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Evaluation of Department of Defense Military Medical Treatment Facility Challenges During the Coronavirus Disease-2019 (COVID-19) Pandemic in Fiscal Year 2021
Rec. A.1.a: The DoD OIG recommended that the Director of the Defense Health Agency, in conjunction with the Secretaries of the Military Departments, establish a working group to address the staffing challenges identified by Military Medical Treatment Facilities during this evaluation. The working group should establish milestones to streamline the hiring process to allow Military Medical Treatment Facilities to more quickly fill civilian staffing positions.
Rec. A.1.b: The DoD OIG recommended that the Director of the Defense Health Agency, in conjunction with the Secretaries of the Military Departments, establish a working group to address the staffing challenges identified by Military Medical Treatment Facilities during this evaluation. The working group should establish milestones to determine if salaries for Military Medical Treatment Facility civilian nurses are commensurate with each facility's local market and if military treatment facilities are able to hire nurses at those salaries. For locations where military treatment facility salaries are not commensurate with the local market, take appropriate actions that will reduce the disparity in those markets.
Rec. A.1.c: The DoD OIG recommended that the Director of the Defense Health Agency, in conjunction with the Secretaries of the Military Departments, establish a working group to address the staffing challenges identified by Military Medical Treatment Facilities during this evaluation. The working group should establish milestones to establish a central authority with the knowledge of the Services' requests for individual and large group deployments of medical staff coming out of Military Medical Treatment Facilities and the associated risks to health care delivery.
Rec. A.1.d: The DoD OIG recommended that the Director of the Defense Health Agency, in conjunction with the Secretaries of the Military Departments, establish a working group to address the staffing challenges identified by Military Medical Treatment Facilities during this evaluation. The working group should establish milestones to assess the ability of Military Medical Treatment Facilities to rapidly receive augmentation of medical staff from the Reserve Components.
Rec. A.2.a: The DoD OIG recommended that the Director of the Defense Health Agency, in coordination with the Secretaries of the Military Departments establish the manpower requirements for the coronavirus disease-2019 mission within the Military Medical Treatment Facilities for the staff required to support testing, vaccinations, contact tracing, and acute respiratory clinics.
Rec. A.2.b: The DoD OIG recommended that the Director of the Defense Health Agency, in coordination with the Secretaries of the Military Departments identify the medical personnel requirements within the Military Medical Treatment Facilities, including clinicians, nurses, and support staff, needed for future long-term pandemic response and biological incidents.
Rec. B: The DoD OIG recommended that the Assistant Secretary of Defense (Health Affairs) develop DoD policy for the maximum consecutive hours to be worked, maximum shifts per week, and coverage of duties when absent, for Military Health System staff (at minimum, active duty military and civilian physicians, nurses, respiratory therapists, and lab technicians) working in Military Medical Treatment Facilities to reduce the physical impacts leading to fatigue and burnout, and develop the appropriate waivers of this policy for Military Health System staff.
Rec. C: The DoD OIG recommended that the Assistant Secretary of Defense (Health Affairs) direct a new or existing working group to develop a plan to implement the recommendations in the Military Health System COVID-19 After Action Report and to develop and monitor milestones for each recommendation.
COVID-19: To Protect Mission Critical Workers, OSHA Could Leverage Inspection Collaboration Opportunities with External Federal Agencies
We recommend the Assistant Secretary for Occupational Safety and Health develop an OSHA outreach plan to be activated during a large-scale safety and health crises such as the COVID-19 pandemic that (a) identifies external federal agencies with enforcement or oversight personnel who are active on worksites and (b) defines how OSHA will collaborate with those agencies. OSHA should consider incorporating into the plan: a process to identify and document highly visible, safety and health hazards for large-scale safety and health crises; a plan for how OSHA will conduct related outreach and training on those hazards and how to refer them to OSHA; and a tracking system for agency referrals and outcomes of those referrals, using that information to periodically inform the outreach plan on areas and types of guidance and training the agencies’ oversight and enforcement personnel need.
We recommend the Assistant Secretary for Occupational Safety and Health explore mechanisms to enhance collaboration, such as MOUs or other written agreements using GAO’s seven key features for collaboration, and incorporate a process to utilize those mechanisms into the outreach plan.
Audit of Entitlements for Activated Army National Guard and Air National Guard Members Supporting the Coronavirus Disease–2019 Mission
Rec. 1.a: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, in coordination with the Under Secretary of Defense for Personnel and Readiness, update the DoD Financial Management Regulation, volume 7A, "Military Pay Policy - Active Duty and Reserve Pay," chapter 27, "Family Separation Allowance" to clearly state that the permanent duty station of a Reserve Component member on temporary duty status is the member's primary residence for the purpose of determining Family Separation Allowance entitlement.
Rec. 1.b: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, in coordination with the Under Secretary of Defense for Personnel and Readiness, update the DoD Financial Management Regulation, volume 7A, "Military Pay Policy - Active Duty and Reserve Pay," chapter 27, "Family Separation Allowance" to clarify that Family Separation Allowance entitlement determination is based on the commuting distance between the member's primary residence and their temporary duty location.
Rec. 2.a: The DoD OIG recommended that the Chief, National Guard Bureau, in coordination with the Director of the Army National Guard and the Director of the Air National Guard, develop and implement policies and procedures to require the Army National Guard and Air National Guard to complete a review of proof of residency documentation when the member's primary residency is established or changed for the Basic Allowance for Housing entitlement to ensure consistency throughout all Army National Guard and Air National Guard units and organizations within every state, territory, and the District. The policies and procedures should also include requirements that: * document a member's primary residence address; * require members to provide proof of their primary residence address; * certify the primary address of members and review supporting documentation; and * provide oversight to ensure primary residence address information is complete and accurate.
Rec. 2.b: The DoD OIG recommended that the Chief, National Guard Bureau, in coordination with the Director of the Army National Guard and the Director of the Air National Guard, develop and implement policies and procedures to outline the process and frequency of recertification for Basic Allowance for Housing entitlement that Army National Guard and Air National Guard officials will use to verify and fully document the dependency status of members to provide clarification to the DoD Financial Management Regulation, volume 7A, chapter 26. These procedures should include: * how recertifications will be completed; * which members will complete a recertification; and * how Army National Guard and Air National Guard officials will provide oversight to ensure that information is complete and accurate.
Rec. 2.c: The DoD OIG recommended that the Chief, National Guard Bureau, in coordination with the Director of the Army National Guard and the Director of the Air National Guard, develop and implement policies and procedures to require Army National Guard and Air National Guard officials to review and document the status of a military member married to another military member regardless of which Military Service, Reserve or Active Component, or Army National Guard or Air National Guard unit the member's spouse belongs to, and identify which member will claim any applicable dependents.
Rec. 2.d: The DoD OIG recommended that the Chief, National Guard Bureau, in coordination with the Director of the Army National Guard and the Director of the Air National Guard, develop and implement policies and procedures to specify the methods for confirming eligibility and paying Family Separation Allowance for Army National Guard and Air National Guard members, in accordance with the DoD Financial Management Regulation, volume 7A, chapter 27, and include the: * timeliness of payments; * determination of Family Separation Allowance eligibility for back to back orders; * members assigned to their normal duty locations; and * requirement to track members to know when they return to their primary residence.
Rec. 2.e: The DoD OIG recommended that the Chief, National Guard Bureau, in coordination with the Director of the Army National Guard and the Director of the Air National Guard, develop and implement policies and procedures to establish formal dissemination and communication procedures for National Guard Bureau policies related to entitlements provided to the Army National Guard and Air National Guard, including the policies in the preceding recommendations. The procedures should require: * creation of a central location where policies and procedures will be kept for easy access by all states, territories, and the District; and * confirmation of receipt from all of the states, territories, and the District when procedures are communicated or obtained.
Rec. 3: The DoD OIG recommended that the Chief, National Guard Bureau, in coordination with the Director of the Army National Guard and the Director of the Air National Guard, develop and implement additional internal control procedures for the review of transactions manually submitted by the Army National Guard and Air National Guard to the payment system prior to payment to ensure the completeness and accuracy of transactions.
The Board Has Effective Processes to Collect, Aggregate, Validate, and Report CARES Act Lending Program Data
Document the key decision to rely on Reserve Bank internal controls to gain assurance over publicly reported transaction-specific CARES Act data, as well as the rationale for that decision.
Identify and document learning opportunities from the CARES Act reporting experience so that they may be used by the Board when future exigent circumstances arise.
Audit of DoD Implementation of the DoD Coronavirus Disease–2019 Vaccine Distribution Plan
Rec. 1: The DoD OIG recommended that the Defense Health Agency Director, with input from the Military Departments, the National Guard Bureau, and other stakeholders, review challenges and difficulties encountered during the distribution and administration of the coronavirus disease-2019 vaccine, compile a report detailing the issues, and determine if corrective actions are necessary to support future pandemic response planning. At a minimum, the review should include the following challenges and difficulties: * Determining the vaccine-eligible population at each military treatment facility; * Reporting vaccine administration data; * Communicating vaccination tier eligibility; * Coordinating tier movement between military treatment facilities; * Allocating vaccine to overseas locations; and * Vaccinating local nationals who work alongside U.S. personnel at overseas locations.
Rec. 2: The DoD OIG recommended that the Assistant Secretary of Defense, Health Affairs form and lead a working group consisting of DoD Components and address the issues identified by the Defense Health Agency.
COVID-19: Delays In Providing Disaster Relief Jeopardize $366 Million Disaster Worker Grant Program
We recommend the Assistant Secretary for Employment and Training: Provide dedicated technical assistance to the states of Florida, New York, Nevada, and Louisiana to assist them in attaining planned goals. If no specific plan of action is provided or is not being met by grantees, ETA should recoup any DWG funding where the states cannot demonstrate their ability to achieve their planned goals by the end of the grant period.
We recommend the Assistant Secretary for Employment and Training: Continue to closely monitor the remaining COVID-19 DWG awards to ensure attainment of performance goals and objectives and provide technical assistance as needed throughout the grant lifecycle. To the extent permitted by law, any of the remaining funds (determined as not needed) should be returned to the Department of Treasury or recouped as soon as practicable so that these funds would become available for other allowable purposes.
We recommend the Assistant Secretary for Employment and Training: Amend TEGL No. 12-19 to include timeline provisions for when disaster relief grantees should begin providing relief to those impacted by a disaster.
We recommend the Assistant Secretary for Employment and Training: Amend TEGL No. 12-19 to include technical assistance provisions for grantees that fail to meet the 60-day requirement for submitting full applications.
Management Advisory Comments Identified in an Audit of the Consolidated Financial Statements, For the Year Ended September 30, 2021
We recommend the Director of OWCP reinforce existing policies and procedures requiring the completion of the review and approval of the Transaction Balancing sign-off sheet timely.
We recommend the Director of OWCP provide additional training to the reviewers regarding responsibilities and expectations when reviewing changes to claimant information to ensure reviews are completed timely and consistently.
We recommend the Chief Financial Officer update the policies and procedures to ensure that when adjustments are made to the financial statements any revised variances that exceed the acceptable threshold are properly investigated and documented, and the flux analysis is reviewed again.
We recommend the Principal Deputy Assistant Secretary for ETA provide reinforcement to reviewers to ensure reviews are performed at the appropriate level of precision.
We recommend that the Principal Deputy Assistant Secretary for ETA implement monitoring controls to periodically verify that management controls for estimates are operating effectively.
We recommend the Assistant Secretary for VETS monitor indirect cost schedule expiration dates and work with grantees to establish new cost allocation plans prior to grant closeout.
We recommend the Chief Financial Officer continue their efforts to fully implement the revised ERM process and ensure that all necessary risk assessments are completed at both the individual agency level and at the agency-wide level.
We recommend the Chief Information Officer enhance vulnerability scanning monitoring controls and procedures to track and remediate outstanding vulnerabilities in a timely manner.
We recommend the Chief Information Officer formally document decisions in a memorandum when accepting the risks of not remediating findings and obtain the necessary approvals from management.
FY 2021 Independent Auditor's Report on the DOL Financial Statements
We recommend that the Assistant Secretary for Employment and Training develop policies and procedures to coordinate with State Workforce Agencies to obtain the necessary information needed to support related balances and assumptions, and to perform benchmarking and/or other analyses to validate new assumptions.
We recommend that the Assistant Secretary for Employment and Training amend policies and procedures to provide specific steps to be performed during the reviews and the documentation requirements, which should include the specific items reviewed, analyses performed, and conclusions reached.
We recommend that the Assistant Secretary for Employment and Training maintain documentation of the reviews performed to assess the reasonableness of the underlying data, assumptions, and formulas used in the models that is sufficiently detailed to evidence the specific items reviewed, analysis performed, and conclusions reached.
We recommend the Acting Chief Financial Officer develop policies and procedures to ensure that the accounting treatment for significant transactions are appropriately researched and documented prior to recording the transaction to the general ledger.
We recommend the Acting Chief Financial Officer enhance management review controls over the amounts that are presented in the notes to the financial statements.
COVID-19: Safety and Remote Learning Challenges Continue for Job Corps
We recommend the Acting Assistant Secretary for Employment and Training require Job Corps: Implement continuous monitoring to ensure centers adhere to Job Corps COVID-19 safety protocols (e.g., use of social distancing markers, installation of barriers, and reconfiguration of furniture to accommodate social distancing).
We recommend the Acting Assistant Secretary for Employment and Training require Job Corps: Develop and revise additional COVID-19 safety protocols as needed to align with current recommendations and advice from the CDC, other experts, and stakeholders to ensure the safety of students and staff at the campuses, including supporting efforts to attain a 100 percent vaccination rate for all students and staff.
We recommend the Acting Assistant Secretary for Employment and Training require Job Corps: Identify learning gaps that occurred during campus closures and procedures Job Corps needs to take to help students fill in those gaps.
We recommend the Acting Assistant Secretary for Employment and Training require Job Corps: Increase oversight of remote instructional programs to ensure students receive the training and resources to complete their programs in a timely way.