Federal Reports

The Office of Inspector General (OIG) contracted with the independent certified public accountingfirm of Harper, Rains, Knight & Company, P.A. (HRK) to audit the financial statements of theU.S. Equal Employment Opportunity Commission (EEOC) for fiscal years ended September 30,2019 and 2018 to provide an opinion on internal control over financial reporting compliance withlaws and other matters, and whether EEOC’s financial management systems substantiallycomplied with the requirements of the Federal Financial Management Improvement Act of 1996(FMFIA).

AU-C 260 Letter - The Auditor's Communication With Those Charged with Governance.

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KPMG LLP (KPMG), under contract with DHS OIG, conducted an integrated audit of DHS’ FY 2019 consolidated financial statements and internal control over financial reporting. KPMG issued an unmodified (clean) opinion over the Department’s financial statements, reporting that they present fairly, in all material respects, DHS’ financial position as of September 30, 2019. However, KPMG identified material weaknesses in internal control in two areas and other significant deficiencies in three areas. Consequently, KPMG issued an adverse opinion on DHS’ internal control over financial reporting. KPMG also reported two instances of noncompliance with laws and regulations. DHS concurred with all of the recommendations.

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The VA Office of Inspector General (OIG) conducted a healthcare inspection to review allegations of deficiencies in quality of care and administrative processes that contributed to two patient deaths by suicide and one patient’s self-harm behavior at the Alaska VA Healthcare System’s (facility) outpatient Social and Behavioral Health Services.Facility staff failed to follow missing patient policies and patients did not have follow-up appointments scheduled. However, the OIG was unable to determine that this contributed directly to adverse patient outcomes. The OIG team substantiated that a patient was evaluated by multiple providers; however, the care provided was adequate.The Same Day Access Clinic had gaps in triage staff coverage, lacked morning psychiatric coverage, and providers were sometimes double booked. The OIG did not identify adverse patient events related to coverage or double booking.Facility medical support assistant staff closed scheduling orders without contacting patients and completing proper documentation. Further, the OIG learned that facility leaders identified a backlog of outstanding scheduling orders and did not report scheduling non-compliance to the Veterans Integrated Service Network. Following an OIG request, facility leaders completed a clinical review of all unresolved scheduling orders. The OIG team substantiated that the facility did not have a missed appointment policy and that facility leaders did not implement Behavioral Health Interdisciplinary Program teams. The OIG team did not substantiate that facility leaders failed to implement an electronic wait list or that an unlicensed social worker provided care to a patient. The facility lacked a Mental Health Treatment Coordinator policy as required and leaders established a policy on February 1, 2019, subsequent to an OIG request. Facility staff did not express concerns about personal safety; however, the facility lacked a behavioral health emergency policy and there were opportunities for improved culture of safety. The OIG made 11 recommendations.