Federal Reports

To obtain further information about this Classified Report, please contact the OIG Office of Counsel at OIGCounsel@oig.treas.gov, (202) 927-0650, or by mail at Office of Treasury Inspector General, 1500 Pennsylvania Avenue, Washington, DC 20220.

To obtain further information about this Classified Report, please contact the OIG Office of Counsel at OIGCounsel@oig.treas.gov, 202 (927)-0650, or by mail at Office of Treasury Inspector General, 1500 Pennsylvania Avenue, Washington, DC 20220.

The COVID-19 pandemic put an unprecedented strain on the nation’s federal healthcare systems. The Pandemic Response Accountability Committee (PRAC) Health Care Subgroup surveyed more than 300 facilities across four federal healthcare programs to determine if the facilities had sufficient medical staff during the pandemic. The VA Office of Inspector General (OIG) reviewed staffing at Veterans Health Administration facilities, the Department of Justice OIG reviewed Federal Bureau of Prisons facilities, the Department of Defense OIG reviewed medical treatment facilities, and the Health and Human Services OIG reviewed staffing within Medicare- and Medicaid-certified nursing homes. Collectively, the IGs learned that most facilities had challenges hiring and maintaining the staff they needed. This joint report provides insights into shortages in personnel positions most commonly reported; factors contributing to personnel shortages reported by facility officials; impacts to the healthcare personnel, the patients, and healthcare services provided by the federal healthcare programs; and strategies to mitigate personnel shortages caused by or exacerbated by the pandemic. Specific insights identified in the report include• Nurses and medical officers were the most commonly reported positions that experienced shortages during the pandemic.• A limited labor pool, noncompetitive pay, COVID-19 requirements, and a challenging hiring process were the most commonly reported factors that contributed to personnel shortages.• A decrease in patient access to care and patient satisfaction and an increase in health care personnel work hours and responsibilities were the most commonly reported impacts resulting from personnel shortages.• Monetary incentives were the most commonly reported strategy to recruit and retain personnel.These insights can help policymakers understand the challenges that federal healthcare programs experienced throughout the pandemic and determine the actions necessary to ensure sufficient staffing for ongoing health care needs and future pandemic response efforts.

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is a multi-year U.S. Government initiative to address the HIV pandemic. The PEPFAR program is managed and overseen by the U.S. Department of State’s Office of the U.S. Global AIDS Coordinator and Health Diplomacy (OGAC). Congress appropriates PEPFAR funds to the State Department, which OGAC allocates to the Peace Corps and other participating Federal agencies. The Peace Corps Office of Global Health and HIV (OGHH) serves as the primary point of contact for Peace Corps posts, regions, and other headquarter offices regarding PEPFAR operations. The regions and posts are responsible for executing PEPFAR programs in the field, including its programmatic and administrative management. The Peace Corps Office of the Chief Financial Officer (OCFO) is responsible for providing OGHH and the posts with the necessary PEPFAR strategic, technical, and financial guidance. OCFO and OGHH issue the Peace Corps PEPFAR Financial Guidance, which posts use to document how they will request, plan, and execute PEFPAR funding and its programs. Post staff must ensure expenses are correctly applied and distributed between PEPFAR and the Peace Corps’ direct appropriations and maintain the appropriate supporting documentation.The objective of this audit was to determine the basis and justifications for allocating expenses to PEPFAR funds following the global evacuation of Volunteers in March 2020.

Applicants for Veterans Health Administration (VHA) positions undergo background investigations as a condition of their employment to help ensure their suitability to care for veterans and be entrusted with sensitive information and resources. A 2018 VA Office of Inspector General (OIG) audit of VHA’s personnel suitability program found inadequate governance of the program and significant deficiencies. This follow-up audit was conducted to evaluate controls over the background investigation process and determine if adjudication actions were completed in a timely manner and reliably recorded.The OIG determined VA did not ensure background investigations were properly completed within required timelines for staff at medical facilities nationwide. Although VA took corrective actions between May 2018 and March 2021 in response to OIG reports, the new controls were not sustained or inadequately mitigated weaknesses. This audit revealed a small number of investigations were not initiated at all, an estimated 7 percent were not begun within the 14 days of an employee’s start date as required (on average 100 days), and about 23 percent were not adjudicated within the required 90-day period (on average over 200 days). Another estimated 48 percent of employees lacked a certificate of investigation to validate a favorable adjudication. These deficiencies allowed some personnel in direct patient care to be employed without vetting for long periods, although identified cases were eventually favorably adjudicated.The identified causes included deficient oversight and insufficient staffing at many levels. VA’s data and information systems were also incomplete and unreliable to track investigative actions. VA concurred with all OIG recommendations to improve monitoring using formal data-testing of relevant systems and a renewed inspection program; assess resources and allocate staff using updated metrics and hiring flexibilities; and ensure sufficient and appropriate data are collected, tested, and accessible through a single system.

Objective: To determine whether the Social Security Administration correctly processed workers’ compensation lump-sum settlements when they determined workers’ compensation offset of Disability Insurance benefits.