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As of April 7, 2020, there are 4984 open recommendations, of which 369 are priority recommendations. Recommendations remain open until they are designated as Closed-implemented or Closed-not implemented.
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Recommendation: To help ensure that quality care is provided to AI/AN people, as part of the implementation of its quality framework, the Secretary of HHS should direct the Director of IHS to ensure that agency-wide standards for the quality of care provided in its federally operated facilities are developed, that facility performance in meeting these standards is systematically monitored over time, and that enhancements are made to its adverse event reporting system.
Agency: Department of Health and Human Services Status: Open Priority recommendation
Comments: HHS concurred with this recommendation and cited steps that have been taken to improve the quality of care in IHS's federally-operated facilities, including establishing an IHS Office of Quality, and developing a dashboard of standards for quality of care. In addition, IHS awarded a contract to a software development firm in December 2018 to design a new adverse event reporting and tracking system for the agency. In March 2020, IHS officials told us the agency had completed a 3 site pilot test, and that one site had gone live with the adverse events reporting system. However, the COVID-19 pandemic response has diverted IHS resources that would be required for successful implementation of the software and adoption of new workflows for managing adverse events. Therefore, IHS is temporarily halting further roll-out of the system until such time as the COVID-19 national emergency has resolved or a determination is made by IHS leadership that IHS can reasonably be expected to manage a new software release despite on-going disaster response. As such, IHS stated that the recommendation should remain open. We agreed and said we will assess HHS's actions once completed.
Recommendation: To help reduce facility costs and reliance on leased space, the Secretary of Defense should direct the Secretaries of the military departments to require that their departments look for opportunities to relocate DOD organizations in leased space to installations that may have underutilized space due to force structure reductions or other indicators of potentially available space, where such relocation is cost-effective and does not interfere with the installation's ongoing military mission.
Agency: Department of Defense Status: Open Priority recommendation
Comments: In December 2015, DOD did not concur with our third recommendation, which was to look for opportunities to relocate DOD organizations in leased space to installations with available space. In its comments, DOD stated that its existing policy requires the effective and efficient use of DOD real property and current initiatives undertaken by each of the military departments and WHS reflect adherence to this policy. DOD further stated that-given that each of the military departments and WHS have implemented initiatives to reduce their dependence on leased space, especially where existing DOD assets may exist-an additional directive from the Secretary of Defense was not required. However, as of December 2017, a DOD official told us that DOD was pursuing an effort to consolidate and standardize leases. The initial focus was on 176 leased facilities within 35 miles of DOD-owned facilities that had underutilized or excess space, and are up for renewal over the next 5 years. According to the DOD official, this effort would develop criteria for reviewing these leases, including a cost-benefit analysis of whether it is feasible to relocate the function from leased space to existing space on an installation. Alternatively, if it is determined that the function cannot be moved, the DOD official stated that DOD would review whether to consolidate the lease to appropriately size the space to the function's requirement. Once this effort is completed, DOD may have opportunities to reduce its leased space at a DOD-wide level. As of March 2018, DOD identified this recommendation's status as "Closed Unresolved," i.e., DOD considers this recommendation to be "closed," but is aware that GAO considers this recommendation "open." GAO also considers this to be a priority recommendation. As of September 2018, the DOD official stated that the effort to consolidate leases was still underway.