Open Recommendations

(U) Rec. B.2.c: The DoD OIG recommended that the Commander, Navy Installations Command, in coordination with the Commander, Navy Region Hawaii, and the Commanding Officer, Naval Facilities Engineering Systems Command Hawaii review and document the prioritization of Joint Base Pearl Harbor?Hickam's future master planning efforts to ensure compliance with Federal and DoD requirements.

(U) Rec. B.2.c: The DoD OIG recommended that the Commander, Navy Installations Command, in coordination with the Commander, Navy Region Hawaii, and the Commanding Officer, Naval Facilities Engineering Systems Command Hawaii review and document the prioritization of Joint Base Pearl Harbor?Hickam's future master planning efforts to ensure compliance with Federal and DoD requirements.

(U) Rec. B.3: The DoD OIG recommended that the Commanding Officer, Naval Facilities Engineering Systems Command Hawaii, in coordination with the Commander, Pearl Harbor Naval Shipyard, direct planning officials to apply environmental threat policies, such as DoD Directive 4715.21 and relevant Unified Facilities Criteria, when developing and executing projects to address the risks identified during the master planning process for the existing dry docks at Pearl Harbor Naval Shipyard.

(U) Rec. B.3: The DoD OIG recommended that the Commanding Officer, Naval Facilities Engineering Systems Command Hawaii, in coordination with the Commander, Pearl Harbor Naval Shipyard, direct planning officials to apply environmental threat policies, such as DoD Directive 4715.21 and relevant Unified Facilities Criteria, when developing and executing projects to address the risks identified during the master planning process for the existing dry docks at Pearl Harbor Naval Shipyard.

(U) Rec. B.4.a: The DoD OIG recommended that once the Shipyard Infrastructure Optimization Program Area Development Plan has been completed, the Commander, Navy Installations Command, in coordination with the Commander, Navy Region Northwest and the Commanding Officer, Naval Facilities Engineering Systems Command Northwest incorporate the results of the Shipyard Infrastructure Optimization Program Puget Sound Naval Shipyard Area Development Plan into the Naval Base Kitsap master plan to comply with the 5?year requirement in accordance with DoD Instruction 4165.70, "Real Property Management," April 6, 2005 (Incorporating Change 1, August 31, 2018).

(U) Rec. B.4.a: The DoD OIG recommended that once the Shipyard Infrastructure Optimization Program Area Development Plan has been completed, the Commander, Navy Installations Command, in coordination with the Commander, Navy Region Northwest and the Commanding Officer, Naval Facilities Engineering Systems Command Northwest incorporate the results of the Shipyard Infrastructure Optimization Program Puget Sound Naval Shipyard Area Development Plan into the Naval Base Kitsap master plan to comply with the 5?year requirement in accordance with DoD Instruction 4165.70, "Real Property Management," April 6, 2005 (Incorporating Change 1, August 31, 2018).

(U) Rec. B.4.b: The DoD OIG recommended that once the Shipyard Infrastructure Optimization Program Area Development Plan has been completed, the Commander, Navy Installations Command, in coordination with the Commander, Navy Region Northwest and the Commanding Officer, Naval Facilities Engineering Systems Command Northwest update the Naval Base Kitsap master plan to include a military installation resiliency component in accordance with section 2864, title 10, United States Code and Unified Facilities Criteria 2?100?01, "Installation Master Planning," September 30, 2020 (Change 1, April 8, 2022).

(U) Rec. B.4.b: The DoD OIG recommended that once the Shipyard Infrastructure Optimization Program Area Development Plan has been completed, the Commander, Navy Installations Command, in coordination with the Commander, Navy Region Northwest and the Commanding Officer, Naval Facilities Engineering Systems Command Northwest update the Naval Base Kitsap master plan to include a military installation resiliency component in accordance with section 2864, title 10, United States Code and Unified Facilities Criteria 2?100?01, "Installation Master Planning," September 30, 2020 (Change 1, April 8, 2022).

(U) Rec. B.5: The DoD OIG recommended that the Commanding Officer, Naval Facilities Engineering Systems Command Northwest, in coordination with the Commander, Puget Sound Naval Shipyard, direct planning officials to apply environmental threat policies, such as DoD Directive 4715.21 and relevant Unified Facilities Criteria, when developing and executing projects to address the risks identified during the master planning process for the existing dry docks at Puget Sound Naval Shipyard.

(U) Rec. B.5: The DoD OIG recommended that the Commanding Officer, Naval Facilities Engineering Systems Command Northwest, in coordination with the Commander, Puget Sound Naval Shipyard, direct planning officials to apply environmental threat policies, such as DoD Directive 4715.21 and relevant Unified Facilities Criteria, when developing and executing projects to address the risks identified during the master planning process for the existing dry docks at Puget Sound Naval Shipyard.

(U) Rec. B.6.a: The DoD OIG recommended that the Program Executive Officer, Program Executive Office Industrial Infrastructure, in coordination with the Commander, Naval Facilities Engineering Systems Command, issue clear and comprehensive guidance that at a minimum identifies and defines Navy planner roles, responsibilities, tasks, and expectations within Naval Facilities Engineering Systems Command and Shipyard Infrastructure Optimization Program to execute master and project planning processes.

(U) Rec. B.6.b: The DoD OIG recommended that the Program Executive Officer, Program Executive Office Industrial Infrastructure, in coordination with the Commander, Naval Facilities Engineering Systems Command, issue clear and comprehensive guidance that at a minimum establishes a defined structure to communicate decisions on master planning and project development processes to all Navy planners located at the shipyards.

The Under Secretary for Health, in conjunction with Veterans Integrated Service Network directors, ensures staff document veterans’ care coordination needs within the Community Care Coordination Plan note for consults assigned a level of care coordination above basic.

The Under Secretary for Health, in conjunction with Veterans Integrated Service Network directors, ensures staff act on consults no later than two business days after receipt and document accordingly.

The Under Secretary for Health, in conjunction with Veterans Integrated Service Network directors, ensures staff schedule community care appointments in a timely manner.

The Under Secretary for Health, in conjunction with Veterans Integrated Service Network directors, ensures staff make three attempts to retrieve medical documentation from non-VA providers.

The Under Secretary for Health, in conjunction with Veterans Integrated Service Network directors, ensures staff implement and sustain processes to monitor the delivery of non-VA home dialysis.

We recommend that the Louisiana Department of Health advise nursing homes to verify that contracted employees' background checks are completed in a timely manner and in accordance with applicable requirements.

We recommend that the Louisiana Department of Health advise nursing homes to contractually require staffing companies to conduct background check searches that include State police records and to adjudicate the results of background checks in accordance with Federal and State requirements.

We recommend that the Louisiana Department of Health advise nursing homes to ensure that all background checks are conducted by authorized agencies and include a search of State police records.

We recommend that the Louisiana Department of Health conduct routine monitoring of nursing homes' compliance with background check requirements.

We recommend that the Louisiana Department of Health make training or informational material available to nursing homes on the applicable Federal and State regulations for background checks of employees.

(U) Rec. 1: The DoD OIG recommended that the Director of the Defense Health Agency identify all specialties, by location, where the managed care support contractor provider network is not meeting DoD access to care standards and, in coordination with the managed care support contractors, develop and implement a plan to bring those provider networks into compliance with the DoD access to care requirements.

(U) Rec. 2.a: The DoD OIG recommended that the Director of the Defense Health Agency, in coordination with the Service Surgeons General, conduct a survey of TRICARE beneficiaries, civilians, and contractors stationed overseas about their access to health care services. The survey should, at a minimum, include the following: i. the overseas locations that have a relatively high number of beneficiaries with concerns about their access to health care. ii. the clinical specialties in overseas locations that beneficiaries have the greatest difficulty accessing. iii. the reasons beneficiaries have difficulties obtaining access to health care in each location and for each…

(U) Rec. 2.c: The DoD OIG recommended that the Director of the Defense Health Agency, in coordination with the Service Surgeons General, use the results of the surveys to develop and implement a plan to address the identified issues.