Federal Reports

This report provides the results of our audit, with the objective to assess First Responder Network Authority’s management and oversight of the Band 14 Incumbent Spectrum Relocation Grant Program.

At the request of the Tennessee Valley Authority's (TVA) Supply Chain, we examined the cost proposal submitted by a company for civil projects and coal combustion residual program management work at TVA's steam electric power plants. Our examination objective was to determine if the company's cost proposal was fairly stated for a planned <br> $200 million contract.In our opinion, the company's cost proposal was overstated. Specifically, we found the company's proposed costs for a Cumberland Fossil Plant project, proposed unit rates for a Bull Run Fossil Plant (BRF) project, and proposed costs for a Paradise Fossil Plant (PAF) project included overstated (1) labor markup and overhead/general and administrative rates, (2) material costs, (3) equipment costs, (4) labor costs, and (5) subcontractor costs. In addition, the company included (1) unsupported costs in the BRF project and (2) excessive project oversight costs in the PAF project. We also found the company's proposed rate attachments included (1) incorrect craft labor rates and (2) noncraft wage ranges that were not reflective of the company's actual wage ranges.We estimated TVA could avoid $19.07 million on the planned $200 million contract by negotiating appropriate reductions to (1) labor markup and overhead/general and administrative rates, material costs, equipment costs, labor costs, and subcontractor costs; (2) unit rates in the BRF proposal; and (3) project oversight costs in the PAF proposal. In addition, we suggest TVA negotiate revisions to the company's contract rate attachments to correct errors and more accurately reflect the company's actual wage ranges.(Summary Only)

The VA Office of Inspector General (OIG) conducted a focused evaluation of the quality of care delivered in the inpatient and outpatient settings of the Providence VA Medical Center (facility). The review covered key clinical and administrative processes associated with promoting quality care—Leadership and Organizational Risks; Quality, Safety, and Value (QSV); Medication Management: Anticoagulation Therapy; Coordination of Care: Inter-Facility Transfers; Environment of Care (EOC); High-Risk Processes: Moderate Sedation; and Long-Term Care: Community Nursing Home (CNH) Oversight. The OIG also provided crime awareness briefings to 24 employees. The facility has generally stable executive leadership and active engagement with patients as evidenced by high satisfaction scores. Organizational leaders support patient safety, quality care, and other positive outcomes (such as initiating processes and plans to maintain positive perceptions of the facility through active stakeholder engagement). The OIG’s review of accreditation organization findings, sentinel events, disclosures, and Strategic Analytics for Improvement and Learning results did not identify any substantial organizational risk factors. The OIG noted findings in four of the six areas of clinical operations reviewed and issued 12 recommendations that are attributable to the Facility Director, Chief of Staff, and Associate Director. The identified areas with deficiencies are: (1) QSV • Review of Ongoing Professional Practice Evaluation data • Completion of individual root cause analyses • Annual patient safety report submission (2) Coordination of Care: Inter-Facility Transfers • Transfer data collection and analysis • Staff/attending physician involvement and countersignature on transfer notes written by acceptable designees • Provision of medical care prior to transfer (3) EOC • Emergency equipment inspection • Documentation of VA Police response time to panic alarm system testing for locked mental health units • Mental health Interdisciplinary Safety Inspection Team training(4) Long-Term Care: CNH Oversight • Oversight committee meeting frequency, membership representation, and program integration • Completion of annual reviews • Cyclical clinical visits

Two Customer Service Representatives were terminated from employment on March 20, 2018, and March 21, 2018, in Joliet, Illinois and Omaha, Nebraska, and two others are facing disciplinary action for the unauthorized release of passenger information. Our investigation determined the employees violated company policy when they accessed company computer systems to provide confidential passenger information to a law enforcement agency without prior approval from the company.

The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) applied to both the Children’s Health Insurance Program and Medicaid. Under CHIPRA, Congress appropriated $3.2 billion for qualifying States to receive bonus payments to offset the costs of increased enrollment of children in Medicaid.