Reports

On March 27, 2020, the President signed into law the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). Among its provisions, the CARES Act provided the U.S. Department of the Interior (DOI) with $756 million to support the needs of DOI programs, bureaus, Indian Country, and the Insular Areas.This report presents the DOI’s progress as of May 31, 2020, in spending CARES Act appropriations. Specifically, the DOI’s expenditures to date total $337,105,190 and its obligations total $448,680,794.We are also monitoring the DOI’s progress on reporting milestones established by the CARES...

The United States faces two simultaneous nationwide public health emergencies: the opioid epidemic and the coronavirus disease 2019 (COVID-19) pandemic. Recently released Centers for Disease Control and Prevention data identified that in 2018, there were nearly 47,000 opioid-related overdose deaths in the United States. In addition, as of May 28, 2020, over 100,000 U.S. citizens had died from complications related to COVID-19. Because of the widespread transmission of COVID-19, Federal, State, Tribal, and local government agencies have recommended and implemented extensive community mitigation activities, including issuing orders to residents to stay at home and practice social distancing, to help slow and contain the spread of the virus. We plan to identify the challenges that opioid treatment programs (OTPs) are encountering during the COVID-19 pandemic. In addition, we will identify the actions that OTPs are taking to address those challenges while ensuring the continuity of needed services and protecting the health and safety of their clients and staff.

The Centers for Disease Control and Prevention has indicated that individuals at high risk for severe illness from coronavirus disease 2019 (COVID-19) are people aged 65 years and older and those who live in a nursing home. Currently, more than 1.3 million residents live in approximately 15,450 Medicare- and Medicaid-certified nursing homes in the United States. As of February 2020, State Survey Agencies have cited more than 6,600 of these nursing homes (nearly 43 percent) for infection prevention and control program deficiencies, including lack of a correction plan in place for these deficiencies. To reduce the likelihood of contracting and spreading COVID-19 at these nursing homes, effective internal controls must be in place. Our objective is to determine whether selected nursing homes have programs for infection prevention and control and emergency preparedness in accordance with Federal requirements.

This work will examine the effectiveness of HHS controls over the awarding and disbursement of $50 billion in Provider Relief Fund (PRF) payments to hospitals and other providers. We will obtain data and interview program officials to gain an understanding of how PRF payments were calculated and review PRF payments for compliance with Coronavirus Aid, Relief, and Economic Security (CARES) Act requirements. Among other things, we will seek to determine whether HHS controls over PRF payments ensured that payments were correctly calculated and disbursed to eligible providers.

Onsite surveys of nursing homes are a fundamental safeguard to ensure that nursing home residents are safe and receive high-quality care. In response to the coronavirus disease 2019 (COVID-19) pandemic, CMS directed State Survey Agencies (SSAs) to suspend standard onsite surveys and most onsite surveys for complaints. CMS directed SSAs to conduct onsite surveys in response to the most serious complaints (i.e., those involving immediate jeopardy) and complaints related to infection control, and to conduct targeted infection control surveys, which are abbreviated surveys focused on infection control policies and practices within facilities. Using recent complaint and survey data for all nursing homes, this study will examine the extent to which SSAs and CMS are conducting onsite surveys in nursing homes related to serious complaints and targeted infection control, in accord with CMS's recent guidance to suspend certain onsite surveys. We will also identify any barriers that CMS and SSAs face in conducting onsite surveys, as well as potential solutions.

On March 27, 2020, the President signed into law the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). Among its provisions, the CARES Act provided the U.S. Department of the Interior (DOI) with $756 million to support the needs of DOI programs, bureaus, Indian Country, and the Insular Areas.The DOI will award most of its CARES Act funding through contracts and financial assistance agreements (such as grants and cooperative agreements). Our past work demonstrates that these awards are a vulnerable area for the DOI. Moreover, awards made as part of emergency response are riskier...

In March 2020, the President signed into law the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) for response and relief related to COVID-19. The Act provided the U.S. Department of the Interior (DOI) with $756 million to support the Bureau of Reclamation, Insular Affairs, Indian Affairs, Indian Education, and Department operations.Oversight of the DOI’s CARES Act spending is critical to safeguard health and safety, water, and Indian education. We describe our four-pronged approach in this document:• Monitoring for early detection• Reviews to uncover and report on wrongdoing•...

On March 27, 2020, the President signed into law the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). Among its provisions, the CARES Act provided the U.S. Department of the Interior (DOI) with $756 million to support the needs of DOI programs, bureaus, Indian Country, and the Insular Areas.This report presents the DOI’s progress as of April 28, 2020, in spending CARES Act appropriations. Specifically:• Total expenditures are $168,719,791 and total obligations are $387,887,389.• A total of 491 grants and contracts have been awarded, with total value of $390,845,278.•...