Open Recommendations

The OIG recommends that the Executive Director for Operations update inspection manual chapters and office instruction(s) addressing qualification programs to include guidance about reminding staff of required refresher training.

The OIG recommends that the Executive Director for Operations implement a centralized, automated information system to ensure compliance with mandatory refresher training requirements.

We recommend the Vice President, Planning and Investor Relations, verify back testing is performed annually.

We recommend the Vice President, Pricing and Contracts, evaluate the program objective to balance operational and financial risks to determine if it should be eliminated or rewritten to clarify intent.

We recommend the Vice President, Pricing and Contracts, report annually the financial hedging program’s impact on fuel rate volatility and its hedging gains/losses in a more transparent manner to the Tennessee Valley Authority Board of Directors, Tennessee Valley Public Power Association, and Tennessee Valley Industrial Committee.

We recommend that OPM address the deficiencies in its audit engagement process and procedures to ensure consistent and efficient access to personnel and information in support of OIG audits.

The OIG recommends the under secretary for health implement procedures to monitor the data used to measure productivity to ensure the data accurately reflect the complete work of clinical resource hub physicians.

The OIG recommends the under secretary for health work with appropriate officials, such as Office of Primary Care and clinical resource hub leaders, to determine whether hub physicians should be subject to existing productivity measures. If so, issue clear hubs guidance requiring adherence; if not, clearly define what should be used, and issue thorough guidance on the steps hubs must take to measure physician productivity consistently.

The OIG recommends the under secretary for health clarify oversight responsibilities for monitoring productivity measures, including detailed procedures and actions that should be taken when thresholds are not met.

Conduct a feasibility study of capturing cost savings resulting from the Regional Transfer Hub initiative and, based on the results, implement tracking of costs related to the initiative.

Establish quantifiable key performance indicators (in coordination with Vice President Processing Operations), including acceptable impacts to service and a trailer utilization target, specific to the Regional Transfer Hub initiative.

Monitor performance of the Regional Transfer Hubs against established goals.

Require Snohomish County to develop and implement written policies and procedures to ensure performance measures are calculated correctly and that source documents to support reported performance measures are retained.

Remedy $11,322 in unsupported questioned costs associated with the following issues:
a. $3,361 in unsupported client flex fund costs.

Remedy $11,322 in unsupported questioned costs associated with the following issues:
b. $7,961 in unsupported other non-personnel costs.

Work with Snohomish County to review historical subrecipient reimbursement requests to identify similar unallowable and unsupported costs and to remedy any questioned costs that are uncovered as a result of the review.

Require Snohomish County develop and implement written policies and procedures to accurately prepare Federal Financial Reports.

Take appropriate action to ensure that the applicable Snohomish County officials responsible for executing the award adhere to the award requirements, to include compliance with the grant award conditions.

Confirm Snohomish County has complied with the three tested award conditions related to grant training, SAM.gov reporting, and pre-publication review of grant-funded materials.

Require Snohomish County to develop and implement written policies and procedures to provide subrecipients with the necessary federal funding information, which will help promote appropriate management of federal funds that complies with the Uniform Guidance and the DOJ Grants Financial Guide.

Require Snohomish County to develop and implement written policies and procedures for subrecipient monitoring, to include financial monitoring and performance monitoring, to ensure Snohomish County monitors subrecipients in accordance with the Uniform Guidance.

Ensure that Snohomish County performs financial monitoring as required by the Uniform Guidance and the recently developed and implemented Snohomish County's monitoring policy.

Require Snohomish County to develop and implement written policies and procedures to ensure subrecipient performance reports are reviewed for accuracy.

Require Snohomish County to develop and implement controls to ensure that only allowable and supported costs are charged to the COSSUP grant.

Remedy $14,075 in unallowable questioned costs associated with the following issues:
a. $2,537 in unallowable fringe benefit costs.