Open Recommendations

We recommend that the FWS require the Department to resolve the Federal share of questioned costs related to the Federal reimbursement for the unsupported in-kind match totaling $104,351.

We recommend that the FWS require the Department to implement internal controls to verify that costs included in the indirect cost base are assigned to the period in which the costs are incurred.

We recommend that the FWS require the Department to develop and implement a process that ensures expenditures claimed on grants are documented in the State financial system at a sufficient level that allows them to be easily traced to a specific grant without requiring manual adjustments.

We recommend that the FWS require the Department to develop and implement controls in the payroll system and accounting system to prevent project ID miscoding.

We recommend that the FWS require the Department to develop and implement monitoring procedures so only eligible costs are charged to grants.

We recommend that the FWS require the Department to implement and train officials involved in subaward management on oversight techniques applicable to Federal requirements and the Department's newly established policies and procedures on subawards.

We recommend that the FWS require the Department to review all open contracts to determine if any contracts should have been subawards. If so, amend the agreements, include all required elements, conduct risk assessments, develop monitoring plans, and report on USAspending.gov.

We recommend that the FWS require the Department to train subrecipients on their responsibilities under Federal awards.

We recommend that the FWS require the Department to develop policies and procedures to better identify and evaluate potential sources of program income on grants.

We recommend that the FWS require the Department to train all personnel responsible for conducting physical inventories on the frequencies required by the State regulations (e.g., annual, biennial, etc.).

The executive director of VA’s Office of Construction and Facilities Management should confirm seismic evaluations are done for all critical and essential buildings in high and very high seismic zones immediately to ensure they meet life, safety, and occupancy performance standards.

We recommend that the National Institutes of Health develop policies and procedures to issue timely management decision letters for foreign grant recipient audit reports, with audit findings, within 6 months of the date HHS accepts the audit report package.

We recommend that the National Institutes of Health follow up with the foreign grant recipients to confirm the 81 outstanding audits were completed, obtain the outstanding audit reports, and issue management decision letters where appropriate.

We recommend that the National Institutes of Health issue management decision letters for the two audit reports that indicated a need for increased monitoring.

We recommend that the National Institutes of Health work with HHS ARD officials to identify foreign grant recipients required to submit annual audit reports and address audit report submission delinquencies by NIH foreign grant recipients.

NIH should ensure that the 6-month requirement for issuing MDLs for all single audits is met.

NIH should ensure that relevant single audit data are available and used by NIH staff to inform decisions about new and ongoing awards.

NIH should use risk to prioritize the issuance of MDLs.

NIH should track the effectiveness of single audit processes and single audits' use.

Update FAA advisory circulars on long-term aviation infrastructure as necessary to address resiliency and climate change effects in airport infrastructure projects.

Develop and implement a strategy to ensure that any new dialysis service contracts follow the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 payment rate requirements.

Ensure the Denver Logistics Center staff complete reports of survey for adjustments to inventory in accordance with VA logistics management policy, and communicate such information to the National Acquisition Center.

Establish and perform routine reviews of the access levels for users with direct access to the inventory management systems and ensure that access is limited to those who have a defined business purpose.

In collaboration with the Office of Information and Technology, ensure the Denver Logistics Center meets physical access, security, and contingency planning requirements for its information management systems.

Establish a connection for Denver Logistics Center inventory data to VA’s Corporate Data Warehouse.

Ensure the Denver Logistics Center develops and maintains comprehensive documentation of the information system to support operations and train information resource management staff.

Determine whether a secure enclosure in which an inmate's movement is significantly restricted due to its size is considered a restraint and, if so, update its policies to make this clear.

Amend its policies to address secure enclosures, including the appropriate use(s) of a secure enclosure, the physical dimensions of an appropriate secure enclosure, the approvals required for using secure enclosures as temporary holding cells, how inmates should be monitored and treated while confined in secure enclosures, and how long an inmate may be kept in a secure enclosure.

We recommend that CPB management require WOMR-FM to identify the corrective actions and controls it will implement to ensure future compliance with Act requirements for open financial records.

We recommend that CPB management require WOMR-FM to identify the corrective actions and controls it will implement to ensure future compliance with CPB’s General Provision requirements for transparency.

The Under Secretary for Health verifies compliance with Veterans Health Administration requirements that all acute sexual assault victim-survivors are offered prophylaxis for pregnancy when clinically indicated and monitors compliance.

The Under Secretary for Health ensures all sexual assault victim-survivors are offered mental health resources, either directly through Veterans Health Administration or through the community and monitors compliance.

The Under Secretary for Health ensures that VA Police Chiefs review facility policy and guidance for police responding to sexual assaults and update to incorporate information on facility-specific resources and processes, including jurisdictional requirements, as warranted, and educates facility police officers as needed.

HRSA should create a document to record lessons learned from managingPRF and submit the document to HHS leadership.

HRSA should expedite audits of provider use of PRF payments.

Embassy Vienna, in coordination with the Bureaus of Overseas Buildings Operations and Consular Affairs, should provide a wheelchair accessible interview window for consular applicants, in accordance with Department standards.

Embassy Vienna, in coordination with the U.S. Mission to International Organizations in Vienna and the U.S. Mission to the Organization for Security and Cooperation in Europe, should bring tri-mission motor pool operations into compliance with Department standards.

Embassy Vienna, in coordination with the Bureau of Overseas Buildings Operations, should comply with Department standards for its non-high-rise residential properties.

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

Embassy Vienna should install server room emergency power-off switches in accordance with Department standards.

CMS should educate enrollees and providers about options for access to overdose-reversal medications, as Narcan and its generic equivalents will no longer be covered by Part D.

Based on the results of the risk assessment, develop and implement a plan to better control, monitor, and block identified data and user activities for its systems.

Establish a process to track and enforce access management requirements for the company’s non-financial systems, including ensuring system owners are aware of and complete required access reviews.

Prioritize and develop a strategy for DT to implement available access management tools across company systems while minimizing disruption to company operations.

We recommend that the Washington State Department of Social and Health Services educate nursing home management that life safety and emergency preparedness training resources are available to nursing home staff.

We recommend that the Washington State Department of Social and Health Services follow up with the 20 nursing homes reviewed in this audit to ensure that these nursing homes have taken corrective actions to address the life safety, emergency preparedness, and infection control deficiencies identified.

We recommend that the Washington State Department of Social and Health Services provide training to State surveyors to ensure that deficiencies related to life safety, emergency preparedness, and infection control are consistently identified.

Rec. 2.b: The DoD OIG recommended that the Director of the Defense Health Agency increase the number of required Prescription Monitoring Program candidate reviews for the Managed Care Support Contractors, while also implementing standard Prescription Monitoring Program processes and review requirements for all DoD medical treatment facilities to include the number of candidates to review.

Rec. 2.c: The DoD OIG recommended that the Director of the Defense Health Agency implement procedures to review DoD medical treatment facility and Managed Care Support Contractor compliance with the Prescription Monitoring Program requirements in Defense Health Agency Instructions and the TRICARE Operations Manual.

Rec. 3.c: The DoD OIG recommended that the Director of the Defense Health Agency develop and implement a process to obtain medical documentation for DoD beneficiaries from DoD medical treatment facilities and other agencies or health insurance providers to support routine monitoring and medical reviews of at-risk beneficiaries.