Open Recommendations

Review the Veterans Health Administrations current methods, assumptions, and approaches used to project medical care budget needs in the annual Presidents Budget to identify any gaps in the process or data limitations, and develop and implement a plan to strengthen the process.

Establish and implement a plan to review current processes and procedures for involving program offices and pertinent subject matter experts in developing the Enrollee Health Care Projection Model inputs for specific areas such as community care, staffing, pharmacy services, and prosthetics services, and formalize the expectations of their involvement in this process, through guidance or protocols.

Develop and implement an approach to estimate medical care personnel needs and costs to increase the accuracy and reliability of information included in the annual Presidents Budget.

Institutionalize a regular cycle of at least quarterly fiscal reviews among assistant under secretaries for health, network directors, and program offices that routinely assess key cost drivers and other areas of concern, such as staffing, community care growth, and local initiatives.

Develop controls that prohibit users from entering invalid dates into the Vehicle Information Transportation Analysis and Logistics system.

Insource highway contract routes when economically advantageous to the Postal Service and implement a waiver process when cost is not a main factor to insource.

Include specific requirements in the job announcements for Postal Vehicle Service operator positions (i.e. starting as part-time flexible or working outside of normal business hours).

Develop and make available the training to obtain a commercial driver's license to interested postal vehicle operators.

Determine complement and work toward hiring the number of schedule examiners vehicle runs and dispatch coordinators needed at nationwide Postal Vehicle Service sites.

Develop a process to ensure site management monitors the accuracy of drivers' license expirations and Department of Transportation physical due dates in the Vehicle Information Transportation Analysis and Logistics system.

FHFA’s DER should create examination procedures to assess the effectiveness of Enterprises’ internal controls and processes in ensuring compliance with FinCEN requirements for SAR filings, to include SAR narratives, and communicate the new procedures to the examiners responsible for this work.

FHFA's DER should consider whether to direct Freddie Mac to file an amended SAR containing a complete narrative for the case identified above, and whether to amend FHFA’s examination procedures to require this step if future examinations uncover a similar issue.

Develop written procedures that clearly define the responsibilities of the federal review process.

Develop written procedures for how errors and discrepancies should be reported, tracked, and resolved, as well as specific criteria for identifying errors or deviations from established standards.

Revise its ASOC review procedures to require an annual reconciliation of SFA funds and to require the review analyst to conduct an analysis of material changes or outliers in the key elements to ensure full compliance with SFA conditions.

Define specific and measurable risk tolerances for changes in key elements and develop related review procedures.

Design specific procedures to ensure (1) appropriate in-depth analysis and review of exceptions, and (2) ensure the review and decision-making process for exceptions and historical data is fully documented in the ASOC workbook.

Develop and document an approach for strategic risk assessments of the ASOC review program.

Conduct a strategic risk assessment to determine the most cost-effective approach to ensuring compliance with ARP and PBGC regulations. This assessment should consider factors such as the number and size of the plans submitting ASOCs and the 30-year duration of the program.

Collaborate with mission directorate officials to update NASA’s ZTA implementation plan to include all efforts associated with the transition to ZTA within the non-corporate environment.

Develop a centralized process to track legacy systems that details deficiencies along with operational, technical, and financial constraints to determine a best course of action for remediation.

Embed OCIO subject matter experts within the mission directorates to provide Agency-focused advocacy and expertise to analyze mission system cybersecurity compatibility and operational complexities.

Engage mission directorates as ZTA pathfinders to identify and evaluate early adoption use-case candidates, employ a “test like you fly” approach, and provide insight to potential issues.

The Chief Information Officer should require a unique system identifier for each new and legacy system in the authoritative inventory be implemented and applied to system records in the other inventory systems.

The Chief Information Officer should improve its annual validation process to ensure that all systems with PII and FTI inventory data are consistently designated across the multiple inventory systems, and that system owners are communicating changes to impacted groups.

The OIG recommends the Director evaluates accessible parking spaces at the circle of the main entrance and ensures access aisles have visible pavement markings and remain available for use.

The OIG recommends facility leaders improve crosswalk visibility and monitor pedestrian safety at the crosswalks until completion.

The OIG recommends facility leaders improve doorway safety at the main entrance.

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 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.

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.

We recommend that the contracting officer require the Plan to return $177,662 to the FEHBP for the questioned uncollected claim overpayments, whether recovered or not, as diligent efforts to recover these overpayments were not made. If the Plan repays these questioned overpayments of $177,662 to the FEHBP during the audit resolution process, then the contracting officer should allow the Plan to keep whatever funds are subsequently recovered for these overpayments.

1. We recommend that the Director of the U.S. Census Bureau consider the actions in the conclusion section of the report when implementing changes to the 2030 redesign.

More clearly define successful prepurchase and postpurchase homeownership counseling outcomes and use these definitions to help establish performance metrics and benchmarks for HUD's Office of Housing Counseling and HUD-approved housing counseling agencies. This should include the types of successful outcomes under the Homeownership Initiative Grant, as well as other positive outcomes for clients that do not involve immediate homeownership.

Implement routine client outcome data analysis to identify trends, quantify performance metrics and benchmarks, and measure the impact of prepurchase and postpurchase counseling on advancing homeownership. This should include routine analysis that HUD's Office of Housing Counseling can implement based on data collected as well as continuing to pursue an updated housing counseling data system to help overcome client outcome data limitations.

Enhance monitoring of HUD-approved housing counseling agencies' performance, to include progress toward the established performance metrics and benchmarks.

We recommend that USAID Power Africa determine the allowability of $41,552 in questioned costs ($41,032 ineligible, $520 unsupported) on pages 11, 13, and 20 to 25 of the audit report and recover any amount that is unallowable.

Mint Director ensures that the Mint recovers its costs on the lost 120 Congressional Award Program (CAP) medals from the sole source contractor.

Mint Director ensures that the Mint engages its Protection officials to complete the Mint’s investigation of the lost CAP medals and conducts a lessons-learned review of this incident to implement process improvements for future contracts.

Mint Director ensures that the Mint conducts a fully competitive solicitation for a source that can provide plating for the CAP medals.