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Data Brief: Telehealth Was Critical for Providing Services to Medicare Beneficiaries During the First Year of the COVID-19 Pandemic
From the Document: "The COVID-19 [coronavirus disease 2019] pandemic created unprecedented challenges for how Medicare beneficiaries accessed health care. In response, the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) took a number of actions to temporarily expand access to telehealth for Medicare beneficiaries. CMS allowed beneficiaries to use telehealth for a wide range of services; it also allowed beneficiaries to use telehealth in different locations, including in urban areas and from the beneficiary's home. Understanding the use of telehealth during the first year of the pandemic can shed light on how the temporary expansion of telehealth affected where and how beneficiaries accessed their health care. This information can help CMS, Congress, and other stakeholders make decisions about how telehealth can be best used to meet the needs of beneficiaries in the future. This data brief provides insight into the use of telehealth in both Medicare fee-for-service and Medicare Advantage during the first year of the COVID-19 pandemic. It is a companion to a report that examines the characteristics of beneficiaries who used telehealth during the pandemic. Another report in this series identifies program integrity concerns related to telehealth during the pandemic."
United States. Department of Health and Human Services. Office of Inspector General
2022-03
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Office of Refugee Resettlement Generally Ensured That Selected Care Provider Facilities for Its Unaccompanied Children Program Complied with Federal Emergency Preparedness Requirements
From the Document: "The Office of Refugee Resettlement (ORR), a program office of the Administration for Children and Families within HHS [U.S. Department of Health and Human Services], manages the Unaccompanied Children (UC) Program, which serves children who have no lawful immigration status in the United States. Because of emergency events in 2017, 2018, and 2019, such as hurricanes and wildfires, we conducted several audits of HHS agencies to identify risks in preparing for and responding to emergency events. This audit continues those efforts. This is the second of two reports addressing emergency preparedness at ORR-funded facilities that provide care to children in the UC Program. The first report addresses communicable disease preparedness, and this report addresses emergency events. This report does not address emergency intake sites that were opened in response to the surge of unaccompanied children that occurred in 2021. Our objective was to determine whether ORR ensured that selected facilities followed Federal requirements in preparing for and responding to emergency events."
United States. Department of Health and Human Services. Office of Inspector General
Grimm, Christi A.
2022-02
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Indian Health Service Use of Critical Care Response Teams Has Helped to Meet Facility Needs During the COVID-19 Pandemic
From the Report in Brief: "Coronavirus disease 2019 (COVID-19) is a highly contagious, sometimes fatal, disease that has disproportionately affected American Indians and Alaska Natives (AI/ANs). The Indian Health Service (IHS) and Tribal health care facilities are the main health care providers for the AI/AN population. Prior OIG [Office of Inspector General] work found that IHS facilities often lacked sufficient staff and had limited access to clinical specialists, as well as finding other quality-of-care concerns. One recent IHS effort to address staffing and quality concerns is its development of Critical Care Response Teams (CCRTs) to support IHS and Tribal facilities in caring for critically ill COVID-19 patients. This study examines IHS's first five deployments of the CCRTs, which provided services to six IHS facilities and three Tribal facilities from June through September 2020."
United States. Department of Health and Human Services. Office of Inspector General
Murrin, Suzanne
2021-09
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Centers for Medicare & Medicaid Services Did Not Account for National Security Risks in Its Enterprise Risk Management Processes
From the Document: "We conducted this audit in response to a congressional request to determine whether the Centers for Medicare & Medicaid Services' (CMS's) enterprise risk management (ERM) process includes steps to identify and assess national security risks. The congressional request was prompted by a previous OIG [Office of Inspector General] audit that determined that national security risks were not adequately considered by the National Institutes of Health (NIH). Specifically, we found that NIH did not consider the risk presented by foreign principal investigators when permitting access to United States genomic data. The Congressmen stated that they are concerned that CMS also has not considered national security risks to its programs."
United States. Department of Health and Human Services. Office of Inspector General
2021-07
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Hospitals Reported That the COVID-19 Pandemic Has Significantly Strained Health Care Delivery: Results of a National Pulse Survey, February 22-26, 2021
From the Document: "This review provides a national snapshot, from the perspective of front-line hospital administrators, on how responding to the COVID-19 [coronavirus disease 2019] pandemic has affected their capacity to care for patients, staff, and communities. This is not a review of the HHS [U.S. Department of Health and Human Service] response to the COVID-19 pandemic. These hospital perspectives reflect a specific point in time--February 22-26, 2021-- provided during a 'pulse survey' (brief interviews) that OIG [Office of Inspector General] conducted with 320 hospitals nationwide. The timing was nearly a year after the World Health Organization declared COVID-19 to be a pandemic on March 11, 2020. [...] We conducted our first pulse survey of challenges that hospitals reported facing in response to COVID-19 during the early weeks of the pandemic. At that time, hospitals reported that they were largely focused on enhancing their capacity to respond to the pandemic. [...] This snapshot from 2021 provides HHS and other decisionmakers with updated information on hospital perspectives. Specifically, this pulse survey offers hospital administrators' perspectives on the most significant strains that the response to COVID-19 has exerted on hospitals, as well as their perspectives on the longer-term implications of these strains." This document includes charts, tables, and graphs to illustrate the text.
United States. Department of Health and Human Services. Office of Inspector General
Grimm, Christi A.
2021-03
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Opioid Use in Medicare Part D During the Onset of the COVID-19 Pandemic
From the Document: "The Office of Inspector General (OIG) has been tracking opioid use in Part D since 2016. From 2016 to 2019, Medicare Part D saw a steady decline in opioid use, along with an increased use of drugs for treatment of opioid use disorder. With the onset of COVID-19 [coronavirus disease 2019] and the new dangers it poses for beneficiaries taking opioids, it is imperative that the Department of Health and Human Services (HHS) closely monitor opioid use during this unprecedented time. This data snapshot describes opioid use in Part D during the onset of COVID-19, focusing on the first 8 months of 2020. For context, this snapshot also provides data on the first 8 months of 2019."
United States. Department of Health and Human Services. Office of Inspector General
Anderson, Miriam; Himmelright, Margaret; Kwong, Jason . . .
2021-02
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Onsite Surveys of Nursing Homes During the COVID-19 Pandemic: March 23-May 30, 2020
From the Document: "We did this review to determine the number and results of onsite surveys of nursing homes during the COVID-19 [coronavirus disease 2019] pandemic. Nursing home residents are particularly vulnerable to infectious diseases such as COVID-19, and infection control has been a persistent problem for most nursing homes. As of November 8, 2020, more than 67,000 nursing home residents have died of COVID-19, which represented almost 30 percent of all COVID-19 deaths in the United States at that time. Onsite State surveys, conducted on behalf of the Centers for Medicare & Medicaid Services (CMS), assess the quality of services in nursing homes, a critical function for protecting residents. CMS changed survey practices in response to the pandemic. These changes-- together with nursing home residents' high-risk status and the importance of the State surveys-- warrant close examination to assess the sufficiency of this oversight."
United States. Department of Health and Human Services. Office of Inspector General
2020-12
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Office of Refugee Resettlement Ensured That Selected Care Providers Were Prepared to Respond to the COVID-19 Pandemic
From the Document: "On July 1, 2019, the Emergency Supplemental Appropriations for Humanitarian Assistance and Security at the Southern Border Act, 2019 (P.L. [Public Law] 116-26) appropriated $2.9 billion for the Unaccompanied Alien Children (UAC) Program. Title IV provided $5 million for the Department of Health and Human Services, Office of Inspector General (HHS-OIG), to conduct oversight of the UAC Program. On January 31, 2020, in response to the coronavirus pandemic in the United States, the Secretary of HHS declared a public health emergency. Following this declaration, Congress appropriated $12 million to HHS-OIG to conduct oversight of HHS's response to the COVID-19 [coronavirus disease 2019] pandemic. Previous HHS-OIG work has focused on the Office of Refugee Resettlement's (ORR's) efforts to ensure the health and safety of children in the UAC Program, including when the UAC Program experiences a sudden change in the number or needs of children. This report builds on our oversight of ORR's efforts to protect children and is one of two reports addressing emergency preparedness at ORR facilities. This report specifically addresses communicable disease preparedness. Our objective was to determine whether ORR ensured that selected care provider facilities (facilities) followed ORR requirements in preparing for and responding to communicable diseases, such as COVID-19."
United States. Department of Health and Human Services. Office of Inspector General
2020-11
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Opioid Treatment Programs Reported Challenges Encountered During the COVID-19 Pandemic and Actions Taken to Address Them
From the Document: "The United States currently faces two nationwide public health emergencies: the opioid crisis and the COVID-19 [coronavirus disease 2019] pandemic. The COVID-19 pandemic has had an impact on the opioid crisis because individuals with an opioid use disorder may be at a higher risk for COVID-19 infection and serious consequences from that disease. In response to the pandemic, the Substance Abuse and Mental Health Services Administration (SAMHSA) granted opioid treatment programs (OTPs) and States increased flexibilities to ensure the delivery of OTP services and to protect patients and staff from COVID-19 to the greatest extent possible. To obtain information on the impact that the COVID-19 pandemic has had on OTPs, we conducted interviews with 142 OTPs. Our objectives were to identify: (1) challenges that OTPs have encountered during the COVID-19 pandemic and (2) actions that OTPs have taken to address those challenges while ensuring the continuity of needed services and protecting the health and safety of their patients and staff."
United States. Department of Health and Human Services. Office of Inspector General
2020-11
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National Snapshot of State Agency Approaches to Child Care During the COVID-19 Pandemic
From the Document: "Federal law requires agencies of State government to prepare for disasters, including the need to provide for the continuity of child care. The Child Care and Development Fund (CCDF) program provides subsidized child care services to low-income families, families receiving temporary public assistance, and families transitioning from public assistance so that family members can work or attend training or education. This audit provides a national snapshot of State-level approaches to some of the issues posed by the ongoing COVID-19 [coronavirus disease 2019] pandemic in child care settings. Our objective was to identify the approaches that CCDF lead agencies in each State and the District of Columbia (State agencies) adopted to ensure access to safe child care as well as to protect the providers rendering that care in their CCDF programs in response to the COVID-19 pandemic."
United States. Department of Health and Human Services. Office of Inspector General
2020-09
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Opioid Use in Medicare Part D Continued to Decline in 2019, but Vigilance is Needed as COVID-19 Raises New Concerns
From the Document: "The United States has been grappling with the opioid crisis for several years. In 2018, nearly 47,000 opioid-related overdose deaths occurred in the United States. The Office of Inspector General (OIG) has been tracking opioid use in Medicare Part D since 2016. In particular, OIG has identified beneficiaries at serious risk of opioid misuse or overdose and prescribers with questionable opioid prescribing for these beneficiaries. This data brief provides important information on opioid use in Medicare Part D in 2019, before the coronavirus disease 2019 (COVID-19) pandemic. This information is critical to understanding trends in opioid use. This data brief will also provide comparison points for a forthcoming OIG data brief, which will examine changes in opioid use that occurred during the pandemic in 2020."
United States. Department of Health and Human Services. Office of Inspector General
2020-08
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OIG Strategic Plan: Oversight of COVID-19 Response and Recovery
From the Introduction: "The emergence of coronavirus disease 2019 (COVID-19) has created unprecedented challenges for the Department of Health and Human Services (HHS) and for the delivery of health care and human services to the American people. HHS leads the Federal public health and medical response during public health emergencies. This plan sets forth the four goals that drive the Office of Inspector General's (OIG's) strategic planning and mission execution with respect to HHS's COVID-19 response and recovery. These goals are to (1) protect people, (2) protect funds, (3) protect infrastructure, and (4) promote effectiveness of HHS programs--now and into the future. This plan highlights our main objectives and ongoing and potential OIG work to advance each goal."
United States. Department of Health and Human Services. Office of Inspector General
2020-05
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Hospital Experiences Responding to the COVID-19 Pandemic: Results of a National Pulse Survey March 23-27, 2020
From the Purpose of the Review: "This review provides the Department of Health and Human Services (HHS) and other decision-makers (e.g., State and local officials and other Federal agencies) with a national snapshot of hospitals' challenges and needs in responding to the coronavirus 2019 (COVID-19) pandemic. This is not a review of HHS response to the COVID-19 pandemic. We have collected this information as an aid for HHS as it continues to lead efforts to address the public health emergency and support hospitals and other first responders. In addition, hospitals may find the information about each other's strategies useful in their efforts to mitigate the challenges they are facing. The hospital input that we describe reflects their experiences and perspectives at a point in time--March 23-27, 2020."
United States. Department of Health and Human Services. Office of Inspector General
Grimm, Christi A.
2020-04
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Communication and Management Challenges Impeded HHS's Response to Zero-Tolerance Policy
From the Document: "Within HHS [U.S. Department of Health and Human Services], the Unaccompanied Alien Children (UAC) Program serves minors who have no lawful immigration status in the United States and do not have a parent or legal guardian available in the United States to provide care and physical custody. A network of more than 100 HHS-funded care provider facilities furnish housing, food, medical care, mental health services, educational services, and recreational activities for such children until HHS can identify an appropriate sponsor (typically a parent or close relative) to take custody. [...] Given the impact of the zero-tolerance policy on vulnerable children and families, OIG [Office of Inspector General] conducted this review to examine challenges that HHS and care provider facilities faced in responding to the policy and carrying out the court-ordered reunification effort. We also sought to identify actions that HHS can take to improve program operations."
United States. Department of Health and Human Services. Office of Inspector General
2020-03
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California Should Improve Its Oversight of Selected Nursing Homes' Compliance with Federal Requirements for Life Safety and Emergency Preparedness
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
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Unaccompanied Alien Children Care Provider Facilities Generally Conducted Required Background Checks but Faced Challenges in Hiring, Screening, and Retaining Employees
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
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Care Provider Facilities Described Challenges Addressing Mental Health Needs of Children in HHS Custody
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
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Southwest Key Programs Did Not Always Comply with Health and Safety Requirements for the Unaccompanied Alien Children Program
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
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'Oversight of Opioid Prescribing and Monitoring of Opioid Use': States Have Taken Action to Address the Opioid Epidemic [presentation]
From the Presentation: "Opioid abuse and overdose deaths are at crisis levels in the United States. [1] More than 47,000 Americans died of drug overdoses involving opioids in 2017. [2] Ensuring the appropriate use and prescribing of opioids is essential to protecting the health and safety of Medicaid beneficiaries and the integrity of the Medicaid program. [...] This report summarizes and compares information provided by the eight States as of October and November 2018."
United States. Department of Health and Human Services. Office of Inspector General
Jarmon, Gloria L.
2019-07
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Separated Children Placed in Office of Refugee Resettlement Care
"In the spring of 2018, the Department of Justice (DOJ) and Department of Homeland Security (DHS) implemented a 'zero-tolerance policy' for certain immigration offenses. As a result, DHS separated large numbers of alien families, with adults being held in Federal detention while their children were transferred to the care of the Office of Refugee Resettlement (ORR) within the Department of Health and Human Services (HHS). On June 26, 2018, in a class action lawsuit, 'Ms. L v. U.S. Immigration and Customs Enforcement (ICE)', a Federal District Court ordered the Federal Government to identify and reunify separated families who met certain criteria. Given the potential impact of these actions on vulnerable children and ORR operations, the Office of Inspector General (OIG) conducted this review to determine the number and status of separated children (i.e., children separated from their parent or legal guardian by DHS) who have entered ORR care, including but not limited to the subset of separated children covered by 'Ms. L v. ICE.' In a separate review, OIG is examining challenges that ORR-funded facilities have faced in reunifying separated children. On the basis of those findings, OIG plans to recommend solutions to improve ORR program operations."
United States. Department of Health and Human Services. Office of Inspector General
2019-01
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Health Resources and Services Administration Has Controls and Strategies to Mitigate Hurricane Preparedness and Response Risk
From the Document: "Three major hurricanes hit the United States between August and September of 2017. On September 8, 2017, the President signed the first Federal Disaster Assistance package of the 2017 hurricane season following Hurricane Harvey. On February 9, 2018, the President signed into law the Bipartisan Budget Act of 2018, which provided disaster relief totaling approximately $89.3 billion. The Department of Health and Human Services received $5.97 billion ($1.07 billion for discretionary programs), of which the Health Resources and Services Administration (HRSA) received $60 million. Our objectives were to identify HRSA's potential risks for preparing for and responding to hurricanes and other natural disasters and to determine whether HRSA has designed and implemented controls and strategies to mitigate these potential risks."
United States. Department of Health and Human Services. Office of Inspector General
Jarmon, Gloria L.
2018-12
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Centers for Disease Control and Prevention Has Controls and Strategies to Mitigate Hurricane Preparedness and Response Risk
"Three major hurricanes hit the United States between August and September of 2017. On September 8, 2017, the President signed the first Federal Disaster Assistance package of the 2017 hurricane season following Hurricane Harvey. On February 9, 2018, the President signed into law the Bipartisan Budget Act of 2018 (P.L. No. 115-123), which provided disaster relief totaling approximately $89.3 billion. HHS [United States Department of Health and Human Services] received $5.97 billion ($1.07 billion for discretionary programs), of which the Centers for Disease Control and Prevention (CDC) received $200 million. Our objectives were to identify CDC's potential risks for preparing for and responding to hurricanes and other natural disasters and to determine whether CDC has designed and implemented controls and strategies to mitigate these potential risks."
United States. Department of Health and Human Services. Office of Inspector General
Jarmon, Gloria L.
2018-11
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Food and Drug Administration's Policies and Procedures Should Better Address Postmarket Cybersecurity Risk to Medical Devices
"We conducted this audit because OIG [Office of Inspector General] had identified ensuring the safety and effectiveness of medical devices and fostering a culture of cybersecurity as top management challenges for HHS [Health and Human Services]. We also considered public and Congressional interest in medical device cybersecurity risks to patients and the Internet of Things. The Food and Drug Administration (FDA) is the HHS operating division responsible for assuring that legally marketed medical devices are safe and effective. Our objective was to determine the effectiveness of FDA's plans and processes for timely communicating and addressing cybersecurity medical device compromises in the postmarket phase."
United States. Department of Health and Human Services. Office of Inspector General
2018-10
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Hospitals Reported Improved Preparedness for Emerging Infectious Diseases After the Ebola Outbreak
"HHS [Health and Human Services] is the lead Federal agency responsible for medical support and coordination during public health emergencies. In 2014, the domestic outbreak of Ebola tested U.S. hospitals' ability to respond to a serious infectious disease. Very few hospitals received suspected or diagnosed cases of Ebola, but the disease's presence caused hospitals to assess and improve their preparedness for Ebola and other EIDs [Emerging Infectious Diseases]. HHS agencies took action to respond to the outbreak, including providing guidance to hospitals and revising requirements for hospital emergency preparedness. This study seeks to assess those efforts by describing the reflections of hospital administrators regarding the outbreak and the actions that hospitals have taken to improve readiness since 2014. This study builds on OIG's [Office of the Inspector General] body of work in emergency preparedness, which includes a prior study of hospital responses to a natural disaster."
United States. Department of Health and Human Services. Office of Inspector General
2018-10
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Office of the Secretary of Health and Human Services Did Not Comply with Federal Regulations for Chartered Aircraft and Other Government Travel Related to Former Secretary Price
"Federal Travel Regulations limit the circumstances in which chartered aircraft can be used for official Government business. The Office of Inspector General (OIG) conducted an audit of the use of chartered aircraft and other types of transportation for Federal travel by the former Department of Health and Human Services (HHS) Secretary Thomas E. Price during his tenure from February 10 through September 29, 2017. HHS's Office of the Secretary had the primary responsibility for decisions that determined the need for chartered aircraft. Our objective was to determine whether former Secretary Price's use of chartered aircraft for Federal travel complied with applicable Federal regulations and HHS policies and procedures. We also reviewed his Federal travel using Military Aircraft (MilAir), commercial flights, and the Presidential fleet."
United States. Department of Health and Human Services. Office of Inspector General
2018-07
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HHS's Office of Refugee Resettlement Improved Coordination and Outreach to Promote the Safety and Well-Being of Unaccompanied Alien Children
"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
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Superstorm Sandy Block Grants: Funds Benefited States' Reconstruction and Social Service Efforts, Though ACF's Guidance Could Be Improved
"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
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Lead Inspector General Quarterly Progress Report on U.S. Government Activities: International Ebola Response and Preparedness
"On March 13, 2014, the Guinean Ministry of Health issued an alert concerning an unidentified disease and, together with the World Health Organization (WHO) and Médecins Sans Frontières (MSF, Doctors Without Borders), began an investigation into an outbreak of hemorrhagic fever. Laboratory tests subsequently confirmed that the outbreak was caused by the Ebola virus. On March 23, 2014, WHO announced the Ebola outbreak in Guinea and within days both Liberia and Sierra Leone reported possible cases of the Ebola virus disease (EVD). The Ebola virus is one of the most infectious viruses known, transmissible through contact with infected bodily fluids, and the resulting disease has a high case fatality rate. The case fatality rate for the current EVD outbreak in West Africa has been 70.8 percent. No cases of EVD had ever been previously recorded in West Africa, and the governments of Liberia, Sierra Leone, and Guinea had limited to no experience in identifying EVD cases or containing the disease. A rapid increase in the number of EVD cases and the spread of the disease in urban settings overwhelmed an already weakened healthcare system and diminished workforce. WHO reported a surge in EVD cases from approximately 132 reported cases in March 2014 to 1,440 cases in July 2014. By the end of July 2014, the Government of Liberia had shut down schools, quarantined communities most at risk, and used military personnel to enforce the quarantine."
United States. Agency for International Development. Office of Inspector General; United States. Department of Defense. Office of the Inspector General; United States. Department of State. Office of the Inspector General . . .
2015-03-31
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Hospital Emergency Preparedness and Response During Superstorm Sandy
"Federal regulations require that hospitals prepare for emergencies including natural disasters. The strength of Superstorm Sandy and the population density of the affected areas placed high demands on hospitals and related services. Prior studies by the Office of Inspector General found substantial challenges in health care facility emergency preparedness and response. In a 2006 study, we found that many nursing homes had insufficient emergency plans or did not follow their plans. In a 2012 followup study, we found that gaps continued to exist in nursing home emergency preparedness and response. […] For this study, we surveyed 174 Medicare-certified hospitals located in declared disaster areas in Connecticut, New Jersey, and New York during Superstorm Sandy. We also conducted site visits to 10 purposively selected hospitals located in areas most affected by the storm. Additionally, we examined information from State survey agency and accreditation organization surveys of hospitals conducted prior to the storm and spoke to surveyors about their survey process related to emergency preparedness. We also interviewed State hospital associations and health care coalitions in the three States."
United States. Department of Health and Human Services. Office of Inspector General
2014-09
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Security Controls Over the Implementation of Personal Identity Verification Cards at the Department of Health and Human Services Were Inadequate Due to Lack of Some Essential Information Security Requirements
"This report provides an overview of the results of our audit of the Department of Health and Human Services (HHS) implementation of Homeland Security Presidential Directive 12 (HSPD-12). Due to the sensitive nature of the specific findings identified during our audit, only a summary of the findings are included in this report. We have provided more detailed information and recommendations to HHS so that it can address the issues we identified. […] The HSPD-12, 'Policy for a Common Identification Standard for Federal Employees and Contractors,' August 27, 2004, mandated the promulgation by 2006 of a Federal standard for secure and reliable forms of identification for Federal employees and contractors and mandates the use of government-wide identification credentials for employees and contractors. The HSPD-12 and other Federal guidance require executive departments and agencies to (1) implement the standard for identification issued to Federal employees and contractors in gaining physical access to controlled facilities and logical access (the authorized and authenticated access to computer applications and data files) to controlled information systems and (2) implement and maintain adequate security for all their support systems and applications. We evaluated HHS' progress in implementing a reliable and effective system of personal identity verification (PIV) in compliance with the HSPD-12. Our objective was to determine whether HHS complied with Federal guidance when implementing its HSPD-12 system."
United States. Department of Health and Human Services. Office of Inspector General
2014-07
