Federal Reports

The OIG conducted an inspection to assess training for VA’s transition to a new electronic health record (EHR) at the Mann-Grandstaff VA Medical Center (facility) in Spokane, Washington. The OIG identified deficiencies related to training content and delivery; the VA Office of Electronic Health Record Modernization’s (VA OEHRM’s) attempt to evaluate training; the contractor’s work on training; and concerns with governance. The OIG observed that facility staff demonstrated a commitment to the EHR transition while prioritizing patient care during a global pandemic.The OIG identified training gaps and factors that may have negatively affected end users’ ability to use the new EHR: insufficient time for training; limitations with the training domain; challenges with user role assignments; and gaps in training support.Facility leaders and staff identified having insufficient time to cover training and that balancing training with duties was challenging. In addition, the user role assignment process resulted in inaccurate assignments that led schedulers to place users in incorrect training. Moreover, VA OEHRM completed assessments of the contractor’s work on training and identified deficits in meeting deadlines, staffing, management, and quality.The OIG determined the VA OEHRM training plan did not include an actionable evaluation of training and VA OEHRM withheld and altered evaluation training data. Further, evidence was not found in the current governance structure that the Veterans Health Administration had a defined role in participating in EHR modernization decision-making or oversight activities.The OIG made eight recommendations to the Deputy Secretary related to training content and delivery, contractor performance, training evaluation, and EHR governance. The OIG made three recommendations to the Under Secretary for Health related to optimizing workflows, tracking EHR patient complaints, and assessment of employee morale.

The Veterans Benefits Administration (VBA) oversees the disability compensation program, providing veterans with monthly payments because of disabilities that occurred during or were aggravated by their military service. VBA’s Office of Field Operations is responsible for ensuring these benefits are provided effectively and efficiently. Sometimes evidence is received that requires decreasing or discontinuing the benefits, called proposals to reduce benefits. Veterans are given time to challenge any proposed action while their benefits continue unchanged. Lengthy delays can waste taxpayer dollars in excessive payments that cannot be recouped.The VA Office of Inspector General (OIG) examined whether the Office of Field Operations managed proposals to reduce benefits by minimizing processing delays and excessive payments. The OIG estimated about 88 percent of claims completed during the review period involved processing delays.The delays occurred because the Office of Field Operations workload distribution strategy prioritized claims involving the granting of benefits. The OIG acknowledges VBA’s goal to ensure these claims are given priority over those that reduce or remove benefits. However, the proposed reductions cannot be allowed to increase in a way that results in excessive payments that could be directed to other eligible beneficiaries or allowable uses.If the Office of Field Operations does not develop an effective strategy to manage the workload, delays and excessive payments will continue, resulting in an estimated $232 million in excessive payments over the next two years. Further, delays may cause unnecessary stress for veterans waiting for final decisions.VBA concurred with OIG recommendations to implement a workload management strategy to distribute and process proposals to reduce benefits that minimizes delays and excessive payments, along with a formal procedure to routinely monitor that strategy. VBA requested closure of the recommendations given changes made since the review, but the OIG will monitor implementation to ensure successful completion.

The Office of the Inspector General conducted a review of the Sequoyah Nuclear Plant Chemistry/Environmental (SQN Chemistry) organization to identify factors that could impact SQN Chemistry’s organizational effectiveness. During the course of our evaluation, we identified behaviors that had a positive impact on SQN Chemistry. These included relationships with most management. However, we also identified behavioral risks related to accountability, relationships within and outside Chemistry, low morale, and ethics. In addition, we identified risks to operations that have hindered SQN Chemistry’s effectiveness. These risks were related to the physical work environment, monitoring effluents and collecting required samples, and inaccurate sample documentation.

Due to an increase in transactions regarding real estate, we performed an evaluation to assess the Tennessee Valley Authority’s (TVA) development and implementation of its strategic real estate plan. However, TVA does not formally have a strategic real estate plan; therefore, we reviewed the goals and objectives of the Strategic Real Estate and Governance (SREG) organization to determine if they were being achieved.We determined SREG has met, or was in the process of meeting, their stated goals and objectives. For example, SREG has (1) improved the condition, safety, and utilization of TVA’s real estate assets and (2) been working to eliminate noncore and underutilized buildings through regional consolidations. However, we identified several areas for improvement that could enable SREG to more effectively accomplish their mission of helping TVA manage real estate assets and align the portfolio with business need. Specifically, (1) SREG does not have an accurate and comprehensive list of all real property, (2) SREG is not always included in, or knowledgeable of, key business decisions that impact real estate, and (3) TVA does not have a centralized real estate function.

The Federal Emergency Management Agency’s (FEMA) Intergovernmental Service Agreement (IGSA) with the Texas General Land Office (TxGLO) was appropriate to ensure direct housing assistance program compliance with applicable laws and regulations. However, FEMA initiated the IGSA without first developing the processes and controls TxGLO needed to administer the program. As a result, FEMA and the State had to develop and finalize implementation guidelines after signing the IGSA, delaying TxGLO’s disaster response. In addition, FEMA disaster personnel had to prepare the necessary guidance, toolkits, and training resources while simultaneously responding to Hurricane Harvey. Also, FEMA used workarounds and TxGLO set up a separate system, creating additional operational challenges and inefficiencies. We made three recommendations to improve future state administered direct housing assistance efforts. FEMA concurred with all three recommendations

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DOJ Press Release: Disbarred Attorney Pleads Guilty To Securities Fraud In Connection With Fraudulent Opinion Letter Scheme