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• Emergency Medical Treatment and Labor Act: The Enforcement Process

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  "The purpose of this inspection was to evaluate the enforcement process for the Emergency Medical Treatment and Labor Act (EMTALA). [...] Congress created a bifurcated enforcement mechanism for EMTALA within the Department of Health and Human Services. The Health Care Financing Administration (HCFA) authorizes investigations of dumping complaints by State survey agencies, determines if a violation occurred, and, if appropriate, terminates a hospital's provider agreement. The Office of Inspector General (OIG) assesses civil monetary penalties against hospitals and physicians and may exclude physicians from the Medicare program for repeated or gross and flagrant behavior. The HCFA 'may' seek the input of the local peer review organization (PRO) after the State's investigation to help determine whether the hospital adequately screened, examined, and treated a patient but 'must' seek PRO input in most circumstances before forwarding a case to the OIG if the alleged violation involves a question of medical judgment."

  United States. Department of Health and Human Services. Office of Inspector General

  2001-01
• Superstorm Sandy Block Grants: Funds Benefited States' Reconstruction and Social Service Efforts, Though ACF's Guidance Could Be Improved

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  "Five States received almost $475 million in Social Services Block Grant funding to help cover social service and reconstruction expenses resulting directly from Superstorm Sandy. When Congress made funds available to States to help pay for their Superstorm Sandy-related expenses, it noted that such funds were 'susceptible to significant improper payments.' Therefore, the Office of Management and Budget instructed Federal agencies to establish additional oversight of the funds. This evaluation examined States' experiences using Superstorm Sandy Social Service Block Grant (Sandy SSBG) funds and Administration for Children and Families (ACF) oversight of these funds."

  United States. Department of Health and Human Services. Office of Inspector General

  Murrin, Suzanne

  2016-09
• Summary Report on State, Local, Private, and Commercial Laboratories' Compliance with Select Agent Regulations

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  From the executive summary: "This report summarizes our reports on eight entities' compliance with these requirements during various periods from November 2003 to September 2005. Pursuant to Office of Management and Budget Circular A-50, CDC [Center for Disease Control and Prevention] was required to resolve the audit recommendations in those reports within 6 months after their issuance. Our objectives were to (1) summarize the findings in our eight individual reports and (2) determine whether CDC had resolved the audit recommendations in those reports in a timely manner."

  United States. Department of Health and Human Services. Office of Inspector General

  2008-01-09
• Emergency Response to Hurricane Katrina: Use of the Government Purchase Card

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  "The Government purchase card program was designed to save the Government money by avoiding costly paperwork and to expedite the process of making purchases. According to U.S. Bank data, Department of Health and Human Services (HHS) cardholders used Government purchase cards to make 851,511 purchases, totaling approximately $458 million in calendar year (CY) 2005. On September 8, 2005, in response to Hurricane Katrina, Congress authorized agencies to streamline certain purchasing requirements for procurement of supplies or services to support rescue and relief operations. In response, the Office of Management and Budget and HHS issued guidance regarding management controls for implementing temporary changes to normal purchasing requirements. Of the total CY 2005 purchases, HHS officials identified 1,139 purchases totaling $2,109,173 related to Hurricane Katrina for the period of August 28 through December 14, 2005. For a stratified sample of 243 of these Hurricane Katrina purchases, we assessed whether the purchases complied with selected requirements for the use of the card. We interviewed 62 cardholders who made these 243 purchases to gather relevant documentation."

  United States. Department of Health and Human Services. Office of Inspector General

  Levinson, Daniel R.

  2007-05
• HHS's Office of Refugee Resettlement Improved Coordination and Outreach to Promote the Safety and Well-Being of Unaccompanied Alien Children

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  "Each year, tens of thousands of children without legal status enter the United States unaccompanied by their parents or legal guardians. These children are referred to as unaccompanied alien children (UAC). Between fiscal years 2012 and 2016, the number of UAC entering the United States increased dramatically. Concern for the safety and well-being of these children after their release from Federal custody has risen in recent years, especially in response to instances of human trafficking. In response to the influx and ongoing concerns, this Office of Inspector General (OIG) report follows up on a 2008 report on the placement, care, and release of UAC. In the 2008 report, OIG found a lack of clarity between the Department of Health and Human Services (HHS) and the Department of Homeland Security (DHS) regarding their roles and responsibilities related to UAC. OIG also found that at the time neither Department checked on children's safety and well-being after their release from Federal custody. OIG recommended that the Departments delineate their roles and responsibilities in a formal agreement."

  United States. Department of Health and Human Services. Office of Inspector General

  Levinson, Daniel R.

  2017-07
• Southwest Key Programs Did Not Always Comply with Health and Safety Requirements for the Unaccompanied Alien Children Program

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  From the Document: "The Office of Refugee Resettlement (ORR) within the Department of Health and Human Services (HHS), Administration for Children and Families (ACF), manages the Unaccompanied Alien Children (UAC) Program. We initiated a series of reviews of UAC Program grantees because, beginning in fiscal year (FY) 2012, there were significant increases in both the number of children served by the UAC Program and program funding, as well as multiple changes to ORR policies beginning in FY 2014. We selected Southwest Key Programs (Southwest Key), a UAC Program grantee, for review because it is one of the largest providers of services to UAC in the United States. We conducted this audit in conjunction with our review of Southwest Key's financial management of Federal funds received to operate the UAC Program (A-06-17-07004). Our objective was to determine whether Southwest Key met applicable safety standards for the care and release of children in its custody."

  United States. Department of Health and Human Services. Office of Inspector General

  2019-08
• Unaccompanied Alien Children Care Provider Facilities Generally Conducted Required Background Checks but Faced Challenges in Hiring, Screening, and Retaining Employees

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  From the Document: "The Office of Refugee Resettlement (ORR), a Program Office of the Administration for Children and Families (ACF) within the Department of Health and Human Services (HHS), manages the Unaccompanied Alien Children (UAC) Program. The Program serves children who arrive in the United States unaccompanied, as well as children who are separated from their parents or legal guardians by immigration authorities. To ensure the health and safety of children in the ORR UAC Program, OIG [Office of Inspector General] is conducting reviews of efforts by ORR facilities to protect all children in their care. Our objectives were to determine whether selected facilities (1) conducted required background checks for staff who had access to children, (2) employed case managers and mental health clinicians who met the minimum education requirements, and (3) faced any staffing challenges related to hiring and retention."

  United States. Department of Health and Human Services. Office of Inspector General

  2019-09
• California Should Improve Its Oversight of Selected Nursing Homes' Compliance with Federal Requirements for Life Safety and Emergency Preparedness

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  From the Document: "In 2016, the Centers for Medicare & Medicaid Services (CMS) updated its life safety and emergency preparedness regulations to improve protections for all Medicare and Medicaid beneficiaries, including those residing in long-term-care facilities (commonly known as nursing homes). The updates included requirements that nursing homes have expanded sprinkler systems and smoke detector coverage; an emergency plan that is reviewed, trained on, tested, and updated at least annually; and provisions for sheltering in place and for evacuation. Our objective was to determine whether California ensured that selected nursing homes in the State that participated in the Medicare or Medicaid programs complied with CMS requirements for life safety and emergency preparedness."

  United States. Department of Health and Human Services. Office of Inspector General

  2019-11
• Care Provider Facilities Described Challenges Addressing Mental Health Needs of Children in HHS Custody

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  From the Document: "By law, ORR [Office of Refugee Resettlement], which is within the Department of Health and Human Services, has custody of and must provide care for each unaccompanied child, including addressing their mental health needs. ORR-funded care provider facilities are required to provide counseling to children and arrange for more specialized mental health services, as needed. We conducted our fieldwork during a time when ORR was experiencing an influx of children. Our findings could inform the Unaccompanied Alien Children Program's preparation for future surges."

  United States. Department of Health and Human Services. Office of Inspector General

  2019-09
• Review of the Food and Drug Administration's Monitoring of Imported Food Recalls

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  "The Food and Drug Administration (FDA) is responsible for safeguarding the Nation's food supply by ensuring that all ingredients are safe and free from disease-causing organisms, chemicals, or other harmful substances. No statute existed prior to 2011 to authorize FDA to require manufacturers/processors or importers to recall food except for infant formula. When a problem arises with a particular food, the manufacturer/processor or importer may voluntarily recall the product. FDA established regulations that are explicit in that the regulations are nonbinding guidance that FDA and the recalling firm should consider in planning and implementing a recall. This report refers to these regulations as 'recall guidance.' The recall guidance specifies that when a firm initiates a recall, FDA should assess the seriousness of the health hazard that the recalled product poses and assign a recall classification of Class I, II, or III. Class I indicates the greatest health hazard. The recall guidance also specifies the elements of the firm's recall process that FDA should monitor and assess in determining the adequacy of the firm's recall. These elements include recall initiation, recall strategy, recall communications, recall status reports, and product disposal."

  United States. Department of Health and Human Services. Office of Inspector General

  Levinson, Daniel R.

  2011-06
• Protecting Public Health and Human Services Programs: A 30-Year Retrospective

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  "The year 2006 marked the Department of Health and Human Services (HHS) Office of Inspector General (OIG) 30th anniversary of the office's creation in 1976, the 20th anniversary of the enactment of the False Claims Amendments Act of 1986, and the 10th anniversary of the Health Insurance Portability and Accountability Act of 1996. These statutes are the legal and policy foundations upon which much of OIG's work is based. This triple anniversary helpfully affords a framework for our narrative. We lay out the initial establishment of the office; examine how its mission was affected by major changes in the structure and size of HHS's programs; and address how the subsequent 1986 and 1996 laws transformed the way in which key initiatives were undertaken to advance the statutory mission of the office to prevent and detect fraud, waste, and abuse and promote the economy and efficiency of HHS programs."

  United States. Department of Health and Human Services. Office of Inspector General

  2007
• State Medicaid Agencies' Initiatives on Health Information Technology and Health Information Exchange

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  The objective of this report was to assess State Medicaid agencies' initiatives on health information technology (HIT) and health information exchange (HIE). "We based this study on a survey of all State Medicaid directors and on structured telephone interviews with State Medicaid directors who reported that they have current or planned HIT and HIE initiatives. In addition, we reviewed documentation of State HIT and HIE initiatives and interviewed officials from the Centers for Medicare & Medicaid Services (CMS) who are involved in this area or in the implementation of Medicaid Information Technology Architecture (MITA), which is a framework developed by CMS to help States modernize their Medicaid information systems."

  United States. Department of Health and Human Services. Office of Inspector General

  2007-08
• Emergency Response to Hurricanes Katrina and Rita: Audit of Program Support Center's Award Process for a Contract With the Nevada Hospital Association

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  "This report provides the results of our audit of the Program Support Center's (PSC) award process for a contract with the Nevada Hospital Association (the Association) of Reno, Nevada. The audit is one of several reviews of procurements by PSC and other components of the Department of Health and Human Services (HHS) in response to Hurricanes Katrina and Rita in 2005."

  United States. Department of Health and Human Services. Office of Inspector General

  2007-04-05
• Emergency Response to Hurricanes Katrina and Rita: Audit of Program Support Center's Award Process for a Contract With the Arkansas Department of Health and Human Services, Office of Minority Health and Health Disparities

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  "This report provides the results of our audit of the Program Support Center's (PSC) award process for a contract with the Arkansas Department of Health and Human Services, Office of Minority Health and Health Disparities (Arkansas), of Little Rock, Arkansas. The audit is one of several reviews of procurements by PSC and other components of the Department of Health and Human Services (HHS) in response to Hurricanes Katrina and Rita in 2005."

  United States. Department of Health and Human Services. Office of Inspector General

  2007-02-20
• Emergency Response to Hurricanes Katrina and Rita: Audit of Program Support Center's Award Process for a Contract With the Louisiana Department of Health and Hospitals, Bureau of Minority Health Access

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  "This report provides the results of our audit of the Program Support Center's (PSC) award process for a contract with the Louisiana Department of Health and Hospitals, Bureau of Minority Health Access (Louisiana), of Baton Rouge, Louisiana. The audit is one of several reviews of procurements by PSC and other components of the Department of Health and Human Services (HHS) in response to Hurricanes Katrina and Rita in 2005."

  United States. Department of Health and Human Services. Office of Inspector General

  2007-02-20
• Emergency Response to Hurricanes Katrina and Rita: Audit of Program Support Center's Award Process for a Contract With the Mississippi Department of Health, Office of Health Disparity Elimination

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  "This report provides the results of our audit of the Program Support Center's (PSC) award process for a contract with the Mississippi Department of Health, Office of Health Disparity Elimination (Mississippi), of Jackson, Mississippi. The audit is one of several reviews of procurements by PSC and other components of the Department of Health and Human Services (HHS) in response to Hurricanes Katrina and Rita in 2005."

  United States. Department of Health and Human Services. Office of Inspector General

  2007-02-20
• Emergency Response to Hurricanes Katrina and Rita: Audit of Program Support Center's Award Process for a Contract With the Texas Department of State Health Services, Office for the Elimination of Health Disparities

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  This report provides the results of our audit of the Program Support Center's (PSC) award process for a contract with the Texas Department of State Health Services, Office for the Elimination of Health Disparities (Texas), of Austin, Texas. The audit is one of several reviews of procurements by PSC and other components of the Department of Health and Human Services (HHS) in response to Hurricanes Katrina and Rita in 2005.

  United States. Department of Health and Human Services. Office of Inspector General

  2007-02-20
• Emergency Response to Hurricanes Katrina and Rita: Audit of Program Support Center's Award Process for a Contract With the Tennessee Department of Health, Office of Minority Health

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  "This report provides the results of our audit of the Program Support Center's (PSC) award process for a contract with the Tennessee Department of Health, Office of Minority Health (Tennessee), of Nashville, Tennessee. The audit is one of several reviews of procurements by PSC and other components of the Department of Health and Human Services (I-IHS) in response to Hurricanes Katrina and Rita in 2005."

  United States. Department of Health and Human Services. Office of Inspector General

  2007-02-20
• Emergency Response to Hurricanes Katrina and Rita: Audit of Program Support Center's Award Process for a Contract With the Alabama Department of Public Health, Division of Minority Health

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  "This report provides the results of our audit of the Program Support Center's (PSC) award process for a contract with the Alabama Department of Public Health, Division of Minority Health (Alabama), of Montgomery, Alabama. The audit is one of several reviews of procurements by PSC and other components of the Department of Health and Human Services (HHS) in response to Hurricanes Katrina and Rita in 2005."

  United States. Department of Health and Human Services. Office of Inspector General

  2007-02-20
• State and Local Bioterrorism Preparedness

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  This Department of Health and Human Services (HHS) Office of Inspector General (OIG) report assesses "State and local health departments' capacity to detect and respond to a bioterrorism event. [...] The findings in this report show that our public health infrastructure has left us under-prepared to detect and respond to bioterrorism. Not all State and local health departments have sufficient staff, surveillance systems, technology, or laboratory capacity to quickly and accurately identify an attack. Some also lack the plans, partnerships, or authorities to adequately respond. Since the anthrax attacks in the Fall of 2001, health departments have started to reassess their preparedness and the Federal government has substantially increased funding to rebuild public health infrastructures. Based on these findings, we conclude that further work is needed at the Federal, State, and local levels to ensure that our countrys public health system is fully prepared to respond to bioterrorism."

  United States. Department of Health and Human Services. Office of Inspector General

  2002-12
• Public Health Laboratory Testing to Detect and Report Biological Threats

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  This Department of Health and Human Services (HHS) Office of Inspector General (OIG) report assesses "the extent to which State public health laboratories have made progress toward the Centers for Disease Control and Prevention's (CDC) requirements intended to decrease the time needed to detect and report biological public health threats." The OIG recommends "that CDC continue to assist States in meeting Cooperative Agreement requirements intended to decrease the time needed to detect and report biological public health threats."

  United States. Department of Health and Human Services. Office of Inspector General

  2008-10
• Review of Texas Department of State Health Services' Bioterrorism and Emergency Preparedness Program

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  "In accordance with sections 301, 317, and 319 of the Public Health Service Act, the Centers for Disease Control and Prevention (CDC) provides funds to State and major local health departments to improve preparedness and response capabilities for bioterrorism and other public health emergencies. From August 31, 1999, to August 30, 2005, CDC provided this funding through the Public Health Preparedness and Response for Bioterrorism Program. Since August 31, 2005, CDC has provided funding through the Public Health Emergency Preparedness Program. We refer to these two programs collectively as 'the program.' In Texas, the Department of State Health Services (the State agency) administers the program and distributes funds to subrecipients to carry out program objectives. For the period August 31, 2004, through August 30, 2006, the State agency claimed program reimbursement totaling $125.5 million. Our objective was to determine whether the costs that the State agency claimed for reimbursement under the program for the period August 31, 2004, through August 30, 2006, were allowable, allocable, and reasonable. Of the $3.1 million in program expenditures that we reviewed for the 2-year period ending August 30, 2006, the State agency claimed $16,158 in unallowable direct program expenditures. In addition, we found that the State agency claimed $3,918 in unallowable indirect program costs. Because the State agency credited the program for the $16,158 in unallowable direct program expenditures, we are questioning only the $3,918 in unallowable indirect program costs. These deficiencies occurred because the State agency did not follow its policies and procedures to ensure that all costs claimed for program reimbursement comply with applicable laws, regulations, and program guidance and because of human error. We recommend that the State agency: refund $3,918 to CDC; strengthen its review process to detect future unallowable costs; and monitor grant-supported activities to ensure compliance with applicable Federal requirements."

  United States. Department of Health and Human Services. Office of Inspector General

  2009-10
• State of Massachusett's Efforts to Account for and Monitor Sub-Recipients' Use of Public Health Preparedness and Response for Bioterrorism Program Funds

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  "The objective of this review was to determine whether the State: (1) properly recorded, summarized and reported bioterrorism preparedness transactions by specific focus area designated in the cooperative agreements; and (2) established controls and procedures to monitor subrecipients expenditures of Centers for Disease Control and Prevention (CDC) funds. We found that the State generally accounted for the Program funds in accordance with the terms and conditions of the cooperative agreement and applicable departmental regulations and guidelines. We recommended that the State implement the random audit component and address problem areas as they are identified to ensure adequate oversight of subrecipients. The auditee concurred."

  United States. Department of Health and Human Services. Office of Inspector General

  2003-10-06
• Review of New York State's Efforts to Account for and Monitor Sub-Recipients' Use of Public Health Preparedness and Response for Bio-terrorism Program Funds

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  "The objectives of this review were to determine whether Health Research, Incorporated (HRI) properly recorded, summarized and reported bio-terrorism preparedness transactions by specific focus areas designated in the cooperative agreements. We found that HRI accounted for bio-terrorism program funds in accordance with the terms and conditions of the cooperative agreements with the Centers for Disease Control and Prevention (CDC). HRI officials stated that CDC funding had not been used to supplant existing State and local programs. We also found that, while HRI implemented procedures to monitor sub-recipient's expenditures of CDC funds, they are not currently performing on-site audits of sub-recipients. However, HRI officials indicated that they plan to implement an on-site audit component to their monitoring procedures in the future. We recommended that HRI continue to implement plans to add an on-site audit component for monitoring sub-recipients and address problem areas, as they are identified. State officials concurred with our recommendation."

  United States. Department of Health and Human Services. Office of Inspector General

  2003-10-15
• State of Ohio's Efforts to Account for and Monitor Sub-Recipients' Use of Public Health Preparedness and Response for Bioterrorism Program Funds

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  "Our objectives were to determine whether the Ohio Department of Health (State agency): (i) properly recorded, summarized and reported bioterrorism preparedness transactions by specific focus area designated in the cooperative agreements and (ii) whether the State agency had controls and procedures to monitor sub-recipient expenditures of CDC funds. Based on our validation of a questionnaire completed by the State agency and our site visit, we found that the State agency generally accounted for program funds by specific focus area. In response to our inquiry as to whether the State agency reduced funding to existing public health programs, State officials replied that program funding had not been used to supplant existing State or local programs. We recommended that the State agency implement the site visit component and address problem areas, as they are identified. The State agency concurred with our findings and recommendation."

  United States. Department of Health and Human Services. Office of Inspector General

  2003-09-19
• State of Michigan's Efforts to Account for and Monitor Sub-Recipients' Use of Public Health Preparedness and Response for Bioterrorism Program Funds

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  "Our objectives were to determine whether the Michigan Department of Community Health (State agency): (i) properly recorded, summarized and reported bioterrorism preparedness transactions by specific focus areas designated in the cooperative agreements and (ii) whether the State agency had controls and procedures to monitor sub-recipient expenditures of Centers for Disease Control and Prevention (CDC) funds. We found that the State agency generally accounted for program funds by specific focus area. In response to our inquiry as to whether the State agency reduced funding to existing public health programs, State officials replied that Program funding had not been used to supplant existing State or local programs. We recommended the State agency continue to comply with the terms and conditions of the cooperative agreements. The State agency concurred with our findings and recommendation."

  United States. Department of Health and Human Services. Office of Inspector General

  2003-10-07
• Nationwide Audit of State and Local Government Efforts to Record and Monitor Subrecipients' Use of Public Health Preparedness and Response for Bioterrorism Program Funds

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  "The objectives of this audit were to determine whether awardees: recorded, summarized, and reported bioterrorism program transactions by focus area in accordance with their cooperative agreements; established procedures to monitor subrecipient expenditures; and had unobligated fund balances as of August 30, 2003. We determined that of the 17 audited awardees: fourteen recorded, summarized, and reported bioterrorism program funds by focus area; six had developed adequate procedures to monitor subrecipient expenditures; and fifteen had unobligated balances of Federal bioterrorism funds as of August 30, 2003 totaling approximately $65 million, or 15 percent of the $428 million awarded. We recommended that CDC: (1) continue to emphasize the requirement to account for funds by focus area; (2) identify awardees that have not accounted for their funds in accordance with the cooperative agreements and ensure that they revise their accounting procedures; (3) provide guidance to awardees on monitoring subrecipient expenditures and measuring subrecipient performance, including emphasizing the need for awardees to make site visits to directly review subrecipients' expenditures and assess subrecipients' progress in improving bioterrorism preparedness; and (4) identify the reasons for large unobligated balances and assist the awardees in overcoming barriers to a more timely use of funds. In response, the CDC officials agreed with the findings and recommendations."

  United States. Department of Health and Human Services. Office of Inspector General

  2004-08-05
• Review of the State of North Carolina's Efforts to Account for and Monitor Sub-Recipients' Use of Public Health Preparedness and Response for Bioterrorism Program Funds: North Carolina Division of Public Health

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  "This final report points out that the North Carolina Division of Public Health (North Carolina) generally accounted for program funds ($25.1 million received for the 4-year period ending August 30, 2003) in accordance with the terms and conditions of the cooperative agreement with the Centers for Disease Control and Prevention (CDC) and applicable departmental regulations and guidelines. Specifically, North Carolina recorded, summarized and reported transactions by specific focus area. In addition, North Carolina's monitoring procedures for contracts and its advanced accounting system facilitated the tracking and monitoring of subrecipient activities and expenditures. Further, North Carolina officials indicated that CDC funding had not been used to supplant programs previously funded by other organizational sources. We recommended North Carolina: (1) develop written policies and procedures for tracking the Program fund activities within the financial accounting system; and (2) implement plans to increase the coordination of monitoring activities for subrecipients of the Program. North Carolina concurred with our findings and recommendations and is taking corrective actions to improve its bioterrorism grant program."

  United States. Department of Health and Human Services. Office of Inspector General

  2003-10-17
• Commonwealth of Virginia's Efforts to Account for and Monitor Sub-Recipients' Use of Public Health Preparedness and Response for Bioterrorism Program Funds

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  "The objectives of this audit were to determine whether the Virginia Department of Health (State agency) properly recorded, summarized and reported bioterrorism preparedness transactions by specific focus area designated in the cooperative agreements and whether the State agency has established controls and procedures to monitor sub-recipient expenditures of Centers for Disease Control and Prevention funds. We found that the State agency generally accounted for Program funds in accordance with the terms and conditions of the cooperative agreement and applicable departmental regulations and guidelines. The State agency had a system to track and monitor sub-recipient activities; such as, application and award processes, grant conditions, ongoing fiscal activities, and reporting. At the time of our review, the State agency had only one sub-recipient, the Division of Consolidated Laboratory Services (Consolidated), a division of the Department of General Services, another Virginia State agency. In its memorandum of agreement with Consolidated, the State agency required no written reports."

  United States. Department of Health and Human Services. Office of Inspector General

  2003-10-17
• State of Illinois' Efforts to Account for and Monitor Sub-Recipients' Use of Public Health Preparedness and Response for Bioterrorism Program Funds

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  "Our objectives were to determine whether the Illinois Department of Public Health (State agency): (i) properly recorded, summarized and reported bioterrorism preparedness transactions by specific focus areas designated in the cooperative agreements and (ii) whether the State agency had controls and procedures to monitor sub-recipient expenditures of Centers for Disease Control and Prevention funds. We found that the State agency generally accounted for program funds by specific focus area. In response to our inquiry as to whether the State agency reduced funding to existing public health programs, State officials replied that Program funding had not been used to supplant existing State or local programs. We recommended the State agency continue to comply with the terms and conditions of the cooperative agreements. The State agency concurred with our findings and recommendation."

  United States. Department of Health and Human Services. Office of Inspector General

  2003-10-31