Federal Reports

The objective of this audit was to determine whether internal controls were in place and effective over the management of the Gold Tree Contract Postal Unit (CPU) by the Sarasota, FL, Main Post Office. The OIG uses data analytics to evaluate the Postal Service’s financial information. Host Administrative Offices (HAO) are required to conduct counts of the CPU stamp stock at least once a year. The data analytics identified that the HAO for the Gold Tree CPU (the Sarasota Main Post Office) did not record a stamp stock count for fiscal year (FY) 2017. The last recorded stamp count was completed in October 2015. We confirmed a stamp stock count had not been conducted in two years. The OIG conducted a count with CPU personnel during our site visit.

The Office of National Drug Control Policy’s (ONDCP) Circular, Accounting of Drug Control Funding and Performance Summary, requires National Drug Control Program agencies to submit to the ONDCP Director, not later than February 1 of each year, a detailed accounting of all funds expended for National Drug Control Program activities during FY 2017. U.S. Immigration and Customs Enforcement (ICE) is a multi-mission bureau, and obligations are reported pursuant to an approved drug methodology. ICE's Homeland Security Investigations (HSI) Domestic Investigations, International Operations (IO) and Office of Intelligence uphold U.S. drug control policy delegated amid the Office of National Drug Control Policy (ONDCP) initiatives, by fully supporting the overall ICE mandate to detect, disrupt, and dismantle smuggling organizations.

The Office of National Drug Control Policy’s (ONDCP) Circular, Accounting of Drug Control Funding and Performance Summary, requires National Drug Control Program agencies to submit to the ONDCP Director, not later than February 1 of each year, a detailed accounting of all funds expended for National Drug Control Program activities during FY 2017. This Performance Summary Report contains the performance measures aligned to drug control decision units as required by the Office of National Drug Control Policy (ONDCP) Circular: Accounting of Drug Control Funding and Performance Summary, dated January 18, 2013. The drug control decision units are as follows: (1) Salaries and Expenses, (2) Air and Marine Interdiction, Operations, Maintenance, and Procurement and (3) Border Security Fence, Infrastructure and Technology.

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 Huntington 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; Medication Management: Anticoagulation Therapy; Coordination of Care: Inter-Facility Transfers; Environment of Care; High-Risk Processes: Moderate Sedation; and Long-Term Care: Community Nursing Home Oversight. OIG also provided crime awareness briefings to 108 employees.The facility’s current leaders have active engagement with employees and patients and are maintaining 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). OIG’s review of accreditation organization findings, sentinel events, disclosures, Patient Safety Indicator data, and Strategic Analytics for Improvement and Learning (SAIL) results did not identify any substantial organizational risk factors. The senior leadership team was knowledgeable of SAIL metrics but should continue to take actions to improve care and performance of selected SAIL metrics, particularly Quality of Care and Efficiency metrics likely contributing to the current 4-star rating.OIG noted findings in four of the clinical operations reviewed and issued seven recommendations that are attributable to the Facility Director, Chief of Staff, Nurse Executive, and Associate Director. The identified areas with deficiencies are:(1) Quality, Safety, and Value (QSV)• QSV Council meeting minutes (2) Coordination of Care: Inter-Facility Transfers• Nurse documentation of transfer assessments/notes• Communication with the accepting facility(3) Environment of Care (EOC)• EOC rounds attendance• Restriction of access to sterile supplies at the representative community based outpatient clinic (CBOC)• Security of biohazardous waste at the representative CBOC (4) Long-Term Care: Community Nursing Home Oversight• Oversight committee representation

In March 2015, the VA Office of Inspector General received a Hotline complaint about development of the Veterans Services Adaptable Network (VSAN) at the Orlando Veterans Affairs Medical Center (VAMC). The complaint stated that VSAN development efforts were not coordinated with the Office of Information and Technology (OI&T) and that project funding was inappropriately coming from medical services appropriations rather than information technology (IT) funding. The OIG substantiated that the VSAN deployment was not fully coordinated with OI&T to ensure it met VA security requirements. Specifically, the Orlando VAMC and OI&T did not perform a security risk assessment or implement security controls to segregate VSAN from VA’s network. The OIG did not substantiate that the Orlando VAMC inappropriately used $5.2 million in medical appropriations funds to purchase IT hardware, software, and installation services in support of the VSAN system. In 2010, the Office of General Counsel (OGC) reviewed the initial $1.7 million procurement and determined that use of the medical services appropriation was proper for the initial VSAN deployment. In July 2017, the OGC reviewed the subsequent $3.5 million procurements to determine whether other medical appropriations could be used to fund additional VSAN IT enhancements beyond the original scope of the project, which was patient Wi-Fi access. The OGC concluded that because the additional $3.5 million of IT procurements were used solely for the patient Wi-Fi network, the expenditure was justified. The OIG accepts OGC’s rationale supporting the use of medical appropriations for these procurements. The OIG recommended that the Executive in Charge for the Office of the Under Secretary for Health, in conjunction with the Executive in Charge for the Office of Information Technology, ensure that all guest Wi-Fi access networks are appropriately secured in accordance with VA policy.