Open Recommendations

We recommend that the Tennessee State Medicaid Agency establish additional policies and procedures to ensure compliance with the STCs including policies and procedures for collecting and maintaining patient-level detail data for the uninsured population for the IMDs.

We recommend that the Tennessee State Medicaid Agency establish additional policies and procedures to ensure compliance with the STCs including policies and procedures for ensuring that the State agency identifies and excludes from its actual CPE calculations the net costs of caring for IMD patients between the ages of 21 and 64.

We recommend that the Tennessee State Medicaid Agency establish additional policies and procedures to ensure compliance with the STCs including policies and procedures for reviewing the actual CPE calculations of its contractor.

OMB should engage with Congress to consider legislating amendments to extend independent oversight of USAspending.gov data submissions, including developing new requirements in consultation with CIGIE and the PRAC for the review of agency award descriptions.

OMB should conduct a feasibility study, in coordination with relevant federal and non-federal stakeholders, as to how to better track and report subrecipient funding.

OMB should engage with Congress to consider legislating amendments to extend independent oversight of USAspending.gov data submissions, including developing new requirements in consultation with the CIGIE and the PRAC for the review of subrecipient reporting.

CMS should monitor national EPSDT performance data for blood lead screening tests and target efforts toward low-performing States to develop action plans for increasing tests, according toMedicaid's schedule

CMS should ensure consistency across CMS guidance related to actionable blood lead reference values and blood lead screening test definitions.

CMS should coordinate with partners to develop and disseminate to State Medicaid agencies educational materials that reaffirmrequirements and schedules for blood lead screening tests

We recommend ICE ERO Assistant Directors for Custody Management and Field Operations update ICE policy and guidance and trackall segregation placements to better ensure that facilities’ use of segregation is necessary and in compliance with detention standards.

We recommend ICE ERO Assistant Directors for Custody Management and Field Operations require all detention facilities to collect andtrack standardized information for all segregation placements and provide this information to ICE for entry into the official system of record (i.e., SRMS).

We recommend ICE’s Records Officer, in conjunction with the Executive Assistant Director for Enforcement and RemovalOperations, update all policies, guidance, and contracts for detention facilities to ensure compliance with the National Archives and Records Administration’s record retention schedules.

Complete a program-specific fraud risk assessment and risk profile for the CDBG and ESG programs, with emphasis on CARES Act funding, and replicate this process to create program-specific fraud assessments and risk profiles for other CPD programs.

Consider OIG's fraud risk inventory to improve CPD's own fraud risk assessments and develop a program-specific fraud risk map and compendium.

Implement efforts to increase the awareness of fraud at all levels (headquarters, field offices, grantees, subrecipients, etc.), including but not limited to regularly publishing articles on known fraud schemes and identified instances of fraud in periodic newsletters or on CPD's intranet website, providing recurring fraud risk trainings to HUD employees and grantees and working with OIG to develop materials to support fraud awareness.

Develop and implement a fraud risk checklist or other instrument as part of CPD's monitoring oversight requirements, to be completed as part of each remote and onsite monitoring review.

Develop and implement a fraud analytics strategy using available data, including but not limited to data and information collected during the grantee risk assessment and monitoring processes, to begin conducting data analyses to identify potential fraud risks for further review.

We recommend the Administrator direct the Associate Administrator for Disaster Assistance to• review the applications of sole proprietors and independent contractors that included numbers of employees but no Employer Identification Number; and• remedy the $3.5 billion disbursed to sole proprietors and $1 billion disbursed to independent contractors that exceeded the amount allowed by SBA’s policy.

Develop an enterprise architecture that includes information security considerations and the resulting risk to the Agency, as well as incorporates STB's existing cyber security architecture.

Implement documented processes for collecting and reporting performance metrics at the organization and system level to assess the effectiveness of Information Security Continuous Monitoring program.

Develop a process to make improvements to the effectiveness of its ISCM program through the collection and reporting of quantitative and qualitative performance metrics, and lessons learned.

We recommend that the Substance Abuse and Mental Health Services Administration update its policies and procedures to require verification that accreditation bodies maintain records that contain sufficient detail to support each accreditation decision.

We recommend the Acting Administrator for the Wage and Hour Division develop a mechanism to enable the agency to determine how effective conciliations are at getting back wage payments to workers, and address any weaknesses identified in ensuring complainants received owed back wages prior to closing conciliations.

Issue addendums to the Resource Management Directive System 2550B travel policy or equivalent to:a. Require approvers to estimate and compare the total cost of temporary change of station versus extended temporary duty travel and authorize the one that is most advantageous for the Agency, cost and other factors considered.b. Require the travel card cancellation and closeout process to occur within a predetermined number of days.

We recommend the Deputy Secretary Ensure the CIO is a lead member with voting rights of DOL’s executive strategy and management boards and committees including but not limited to the MRB, ESS Governance Board, COVID-19 Coordination team, and ERMC.