Open Recommendations

The OIG recommends the Director ensures staff have adequate hand hygiene supplies in or near soiled utility rooms that contain biohazardous materials.

The OIG recommends facility leaders ensure the facility policy for communication of test results and service-level workflows comply with VHA requirements, and staff implement processes to monitor patient notification of test results.

The OIG recommends facility leaders increase hiring efforts for the vacant social work positions in the Housing and Urban Development"Veterans Affairs Supportive Housing program, and in the interim, provide staff to support program enrollment.

The Hampton VA Medical Center Director directs nursing leaders to review records of medical intensive care unit patients with Clinical Institute Withdrawal Assessment of Alcohol Scale Protocol orders to confirm that medical intensive care unit nurses document Clinical Institute Withdrawal Assessment of Alcohol Scale scores consistent with patients documented behavior and symptoms and takes actions to address any deficiencies that are identified.

The Hampton VA Medical Center Director confirms that nursing leaders complete review of records of medical intensive care unit patients with Clinical Institute Withdrawal Assessment of Alcohol Scale protocol orders to determine the extent with which administration of medication is in adherence with the protocol and take actions to address any deficiencies that are identified.

The Hampton VA Medical Center Director ensures that a review of records of medical intensive care unit patients with Clinical Institute Withdrawal Assessment of Alcohol Scale protocol orders is completed by nursing leaders to (a) assess the degree of compliance with completing Clinical Institute Withdrawal Assessment of Alcohol Scale assessments based on the last assessment score, as outlined in the protocol, and (b) review the actual time Clinical Institute Withdrawal Assessment of Alcohol Scale is completed in comparison to the time it is documented in the electronic health records to identify significant delays, if any, and based on analysis of…

The Hampton VA Medical Center Director works with the facility Chief of Staff to ensure medical intensive care unit providers have reviewed a clinical practice guideline specific to management of alcohol withdrawal from an accredited source, such as The American Society of Addiction Medicine.

The Hampton VA Medical Center Director confirms completion of a review to assess the current process for communicating unit-based medication shortages and how staff can confirm the availability of shortage medications when use of the medication is key to the patients treatment, and updates the process as warranted.

The Hampton VA Medical Center Director ensures that the facilitys Alcohol Withdrawal Management standard operating procedure aligns with requirements for a standard operating procedure outlined in Veterans Health Administration Notice 2024-09.

The Hampton VA Medical Center Director confirms that training requirements specified in Veterans Health Administration Notice 2024-09 are completed, training attendance is tracked, and a process is in place to monitor accurate and consistent use of the alcohol withdrawal scale identified in the facility standard operating procedure

We recommend the Regional Administrator, FEMA Region IV, complete the insurance review for Jacksonville State and offset and disallow $14.1 million ($10.6 million Federal share) of ineligible duplicate benefits for insurance proceeds received by Jacksonville State not previously reduced from the corresponding project worksheet amounts.

We recommend the Acting Director for ICE review and revise as needed Memoranda of Agreement and the Joint Concept of Operations between ICE and the U.S. Department of Health and Human Services and continue to work on information-sharing agreements related to unaccompanied alien children.

We recommend the Acting Director for ICE develop and implement a formal process to review ICE system data and identify inaccurate and incomplete addresses for unaccompanied alien children and share this information externally with the U.S. Department of Health and Human Services.

We recommend the Acting Director for ICE develop and implement a plan to address the backlog of unserved Notices to Appear for unaccompanied alien children, including a timeframe for reducing the backlog.

We recommend the Acting Director for ICE update existing guidance, such as the Field Office Juvenile Coordinator Handbook, to clarify how ICE ERO officers should elevate concerns regarding the safety or circumstances of unaccompanied alien children and ensure wide dissemination of all updated guidance.

Establish clearly defined, measurable objectives for the ECAP program that align with the expectations in the GAO Green Book and FS policy.

Establish and document a hiring strategy to ensure FS has sufficient qualified staff at all levels of the ECAP Program.

Document a knowledge management plan to ensure all relevant information from ECAP program activities is communicated and provided to successors.

Develop and implement clear guidance for State Administering Agencies (SAA) to help ensure SAAs provide subrecipients with the necessary federal funding information, which will ensure appropriate management of Victims of Crime Act (VOCA) funds that is compliant with the Uniform Guidance and the Department of Justice (DOJ) Grants Financial Guide.

Ensure New York OVS's subaward allocation methodology is compliant with the Uniform Guidance and the DOJ Grants Financial Guide and assess the potential systemic nature of our finding present with other SAAs.

Ensure that Safe Horizon develops and implements written program policies and procedures for compiling and prorating performance data to ensure VOCA-funded program performance reports are supported and accurate.

Ensure that Safe Horizon establishes necessary controls and processes to separately account for federal award funds in compliance with the DOJ Grants Financial Guide and Uniform Guidance.

Ensure that Safe Horizon develops and implements written policies and procedures to ensure: (a) grant management roles and responsibilities are clearly defined for its personnel and (b) reimbursement requests are prepared appropriately.

Ensure Safe Horizon develops and implements written policies and procedures for administering VOCA-funded client assistance in accordance with VOCA Guidelines

Work with New York OVS to develop and implement written policies and procedures in accordance with the Uniform Guidance and OVC best practices to ensure subrecipients are provided with adequate guidance for time and effort reporting.