Open Recommendations

Embassy Dili should bring the safety, health, and environmental management program into compliance with Department standards.

Embassy Dili, in coordination with the Bureau of Overseas Buildings Operations, should perform seismic safety evaluations of all its residential properties in accordance with Department standards.

Embassy Dili should submit its hotel and restaurant report in accordance with Department standards.

Embassy Dili should use the Inventory and Logistics Management System loanable property module to issue and track information technology assets.

Embassy Dili should retire records in accordance with Department records management standards.

Embassy Dili should install an emergency power-off switch in the unclassified server room in accordance with Department standards.

Embassy Dili should complete all information systems security officer responsibilities in accordance with Department standards.

Embassy Dili should ensure the local information technology configuration control board performs its responsibilities in accordance with Department standards.

Issue guidance that clearly defines responsibilities and outlines expectations for those serving in Examiner Commissioning Program support roles, including (a) mentors on their support during an examiner’s acting examiner in charge assignment; (b) regional training leads on their support during rotations; and (c) field managers on providing support, identifying examinations, and selecting acting examiner in charge assignments for examiners pursuing commissioning.

Develop a standardized process for Supervision Learning and Development and the regions to collaborate when providing supplemental Examiner Commissioning Program support to examiners who are preparing for the Examiner Commissioning Program.

Assess the current examiner in charge case study assessment feedback process and determine how to enhance the feedback provided to examiners while safeguarding the content of the examiner in charge case study assessment. Based on the results of the assessment, update guidance to clearly outline expectations for delivering specific, actionable examiner in charge case study assessment feedback and develop and implement training on those expectations.

The Veterans Integrated Service Network Chief Medical Officer oversees the healthcare system’s privileging processes.

The Chief of Staff ensures designated staff complete the Comprehensive Suicide Risk Evaluation the same calendar day, when logistically feasible and clinically appropriate, for all ambulatory care patients with a positive suicide risk screen.

The Chief of Staff ensures clinical staff notify the suicide prevention team when patients report suicidal behaviors during the Comprehensive Suicide Risk Evaluation.

The Office of Programs should create a cover sheet with a checklist that allows the Contracting Officer’s Representative to verify that the following requirements have been met: The claims examiner signed and dated form G-137 SUP, via a written/electronic signature or a “sticky note;” and Current medical evidence is included in each medical opinion.

The Office of Programs should work with the RRB’s Executive Committee to determine which RRB employees should be provided annual training regarding the review and acceptance of medical opinions to ensure RRB’s internal controls for the usage of medical opinions in the disability determination process are designed and operating effectively.

The Office of Programs should require a secondary authorizer to review each medical opinion.

The Office of Programs should create controls that require the Contracting Officer’s Representative to sample medical opinions and review them for acceptability on a routine basis.

The Office of Programs should retrain the examiners to sign each medical opinion they review and ensure that current medical evidence is included.

The Office of Programs should work with the RRB’s Executive Committee to retrain applicable employees regarding the medical opinion approval process and document retention requirements to ensure the evaluation of medical opinions follows RRB’s internal controls.

The Office of Programs should review the 11 incomplete medical opinions to determine if the missing information from the medical opinion would change the disability determination and expand the review of medical opinions if disability determinations are found to be impacted.

The Office of Programs should work with Office of Administration to determine if additional Contracting Officer’s Representatives are required to ensure proper contractual and technical oversight and monitoring of the medical opinions contract.

The Office of Programs should work with Office of Administration to revise the approval process in the Disability Claims Manual so that claims examiners do not approve payment for medical opinions and develop a new process for the Contracting Officer’s Representative or the Alternate Contracting Officer’s Representatives to review and approve payment for medical opinions.

The Office of Programs should work with Acquisition Management to include language in the next medical services contract requiring that if consultation sessions with the consultants occur online, payments are in 30-minute increments in which consultation occurs, instead of the entire 4-hour window.

The Office of Programs should work with Acquisition Management to modify the language in Contract 1, dated December 1, 2020, to require that the medical services contractor submit medical licenses, insurance, and annual training certifications on an annual basis.