Open Recommendations

We recommend that the Grantee establish policies and procedures for the timely submission of progress reports in accordance with the Uniform Guidance and grant agreement.

Revise policies and procedures over the maintenance of accounting records to ensure costs incurred for Federal awards are accurately recorded and supported by documentation prior to reporting financial information to ARC.

Work with ARC to resolve the questioned costs totaling $4,231 of ARC funded personnel cost and $324 of ARC funded fringe benefits cost.

We recommend that the Acting PBS Commissioner provide PBS project teams with annual training on the CMc project delivery method and any updated policies or guidance implemented in response to the audit findings. Training should provide PBS project teams with sufficient information to: 1. obtain adequate price competition for construction work under the GMP; 2. negotiate fees for contract modifications (overhead and profit) based on actual overhead rates and the degree of cost risk for each change; and 3. comply with FAR and GSAR accounting and auditing requirements to ensure that the government only pays actual costs under the GMP.

We recommend that the Acting PBS Commissioner update existing controls to ensure proper award and administration of CMc contracts. Revise the existing contract file checklist to include specific requirements for CMc contracts. Implement procedures to review, authorize, and monitor all contract changes that impact the GMP. Implement procedures to delegate Cost Accounting Standards administration responsibilities within PBS to a cognizant federal agency official. Implement procedures for interagency coordination when PBS is not the cognizant federal agency for a contractor. Develop and implement consistent monthly reconciliation procedures to ensure that contractors properly accumulate and record incurred project costs. PBS should also…

We recommend that the Acting PBS Commissioner implement a comprehensive review and approval process governing the use of the CMc project delivery method for new projects and those projects in the early stages of development (e.g., acquisition planning phase). At a minimum, the process should ensure that: 1. the assigned project teams clearly understand the requirements of the CMc project delivery method; and 2. effective internal controls are in place to properly award and administer the underlying CMc contracts.

We recommend that the Acting PBS Commissioner review PBS’s open CMc contracts to determine if PBS can make retroactive adjustments to recover the taxpayer dollars that have been used to pay excessive fees on CMc contracts.

We recommend the Senior Vice President, Transmission, evaluate Transmission’s budget and determine if there are other funds that could be reallocated to close the funding gap or consider escalating the request for additional funding.

The Country Director establishes memoranda of understanding, or informal cooperative agreements with clear expectations, with the Madagascar ministries of health, education, and agriculture.

The Office of Volunteer Recruitment and Selection, the Office of Communications, and the post work together to develop and implement strategies that address applicant concerns specific to Madagascar to increase application and retention rates.

The Country Director develops post-specific procedures for receiving and responding to Safety and Security incidents, to include roles and responsibilities, and then trains staff in those procedures.

The Country Director works with the Peace Corps Medical Officers to ensure they visit more Volunteers at site per TG 204 requirements and develop and implement a plan to assess healthcare facilities and consultants as required.

The Under Secretary for Health ensures that VA homeless program staff consistently document, in patients electronic health records, the clinical information from the Homeless Operations Management and Evaluation System.

The Under Secretary for Health makes certain that a suicide risk screening is completed with patients during intake into VA homeless programs, consistent with Veterans Health Administration policy.

The Under Secretary for Health ensures that staff complete suicide risk screening in response to danger of self-harm identified in the Homeless Operations Management and Evaluation System.

The Under Secretary for Health makes certain that homeless program staff provide and document care coordination to address patients mental health and substance use disorder treatment needs as identified in the Homeless Operations Management and Evaluation System.

Executive leaders ensure there are clear signs during construction projects, and maps at the main entrance information desk to help veterans navigate the facility.

The Medical Center Director ensures contractors inspect and test emergency generators and fire doors as required, and staff report compliance to an environment of care committee.

The Associate Director of Patient Care Services/Nurse Executive ensures nursing staff monitor proper food clean-up, storage, and disposal in the Mental Health Residential Rehabilitation Treatment Program’s areas.

The Medical Center Director ensures staff refill hands-free sanitizer dispensers throughout the facility.

Executive leaders ensure staff develop service-level workflows for the communication of test results for each service.

The Medical Center Director ensures staff implement a process to monitor providers’ compliance with communicating abnormal test results to patients.

Executive leaders ensure staff complete improvement actions from root cause analyses within one year.

Facility leaders ensure providers who order tests communicate the results to patients timely.

Some or all of the recommendation is not publicly available due to concerns with information protected under the Freedom of Information Act.