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Recommendations Database

GAO’s recommendations database contains report recommendations that still need to be addressed. GAO’s priority recommendations are those that we believe warrant priority attention. We sent letters to the heads of key departments and agencies, urging them to continue focusing on these issues. Below you can search only priority recommendations, or search all recommendations.

Our recommendations help congressional and agency leaders prepare for appropriations and oversight activities, as well as help improve government operations. Moreover, when implemented, some of our priority recommendations can save large amounts of money, help Congress make decisions on major issues, and substantially improve or transform major government programs or agencies, among other benefits.

As of October 25, 2020, there are 4812 open recommendations, of which 473 are priority recommendations. Recommendations remain open until they are designated as Closed-implemented or Closed-not implemented.

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Results:

Subject Term: "Native American health services"

3 publications with a total of 9 open recommendations
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Bureau of Indian Education: Actions Needed to Improve Management of a Supplemental Education Program
GAO-20-308, Apr 9, 2020
Director: Melissa Emrey-Arras
Phone: (617) 788-0534

5 open recommendations
Display
Recommendation: The Director of the Bureau of Indian Education should develop a systematic process for identifying JOM contractors and maintaining an accurate and complete list of contractors and other relevant information about contractors, such as the amount of JOM funds they receive and their current points of contact. (Recommendation 1)

Agency: Department of the Interior: Bureau of Indian Education
Status: Open

Comments: Interior concurred with this recommendation. They expect their newly expanded JOM program workforce to develop, publish and implement a comprehensive JOM policy and procedure that includes a systemic process for identifying JOM contractors and maintaining a complete and accurate list of contractors. We will monitor the progress of these efforts.
Recommendation: The Director of the Bureau of Indian Education, in coordination with the Bureau of Indian Affairs as needed, should establish a process to track and monitor the timeliness of JOM disbursements to non-tribal contractors, including identifying a target date for disbursing funds to these contractors. (Recommendation 2)

Agency: Department of the Interior: Bureau of Indian Education
Status: Open

Comments: Interior concurred with this recommendation. The BIE, BIA and other partners will work collaboratively to publish and implement a policy and procedure that accurately tracks and monitors timely disbursement of JOM funds to these contractors. We will monitor the progress of these efforts.
Recommendation: The Director of the Bureau of Indian Education should develop a timeline to assess the usefulness of the information they are collecting from JOM contractors and update JOM information collection forms, including converting them to an electronic format to reduce the burden on contractors to complete them. (Recommendation 3)

Agency: Department of the Interior: Bureau of Indian Education
Status: Open

Comments: Interior concurred with this recommendation. They expect that their newly expanded JOM program workforce will expedite the BIE's review and information collection efforts. We will monitor the progress of these efforts.
Recommendation: The Director of the Bureau of Indian Education should develop and provide training to contractors on administering the JOM program. (Recommendation 4)

Agency: Department of the Interior: Bureau of Indian Education
Status: Open

Comments: Interior concurred with this recommendation. SIE and JOM staff will be tasked with developing a technical assistance framework for contractors and a training plan as part of the wider JOM program policy and task procedures. We will monitor the progress of these efforts.
Recommendation: The Director of the Bureau of Indian Education should clearly define the roles and responsibilities and identify the staff necessary for conducting critical JOM functions, including administering contracts, reviewing the appropriateness of contract types, and overseeing those contractors that are subject to BIE oversight. (Recommendation 5)

Agency: Department of the Interior: Bureau of Indian Education
Status: Open

Comments: Interior concurred with this recommendation. The BIE, BIA and other partners plan to work collaboratively to develop an inter-bureau policy that clearly identifies each agency's roles and responsibilities. They are also developing a data-informed workforce analysis for the JOM program. They will continue to develop and implement a data-informed workforce strategy to identify human capital needs and clearly identifies and assigns critical JOM-related functions among BIE divisions, offices and staff. We will monitor the progress of these efforts.
VA and Indian Health Service: Actions Needed to Strengthen Oversight and Coordination of Health Care for American Indian and Alaska Native Veterans
GAO-19-291, Mar 21, 2019
Director: Jessica Farb
Phone: (202) 512-7114

3 open recommendations
Display
Recommendation: As VA and IHS revise the MOU and related performance measures, the Secretary of Veterans Affairs should ensure these measures are consistent with the key attributes of successful performance measures, including having measurable targets. (Recommendation 1)

Agency: Department of Veterans Affairs
Status: Open

Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Recommendation: The Secretary of Veterans Affairs should, in consultation with IHS and tribes, establish and distribute a written policy or guidance on how referrals from IHS and Tribal Health Program (THP) facilities to VA facilities for specialty care can be managed. (Recommendation 2)

Agency: Department of Veterans Affairs
Status: Open

Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Recommendation: As VA and IHS revise the MOU and related performance measures, the Director of IHS should ensure these measures are consistent with the key attributes of successful performance measures, including having measurable targets. (Recommendation 3)

Agency: Department of Health and Human Services: Public Health Service: Indian Health Service
Status: Open

Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Indian Health Service: Agency Faces Ongoing Challenges Filling Provider Vacancies
GAO-18-580, Aug 15, 2018
Director: Jessica Farb
Phone: (202) 512-7114

1 open recommendations
Display
Recommendation: The Director of IHS should obtain, on an agency-wide basis, information on temporary provider contractors, including their associated cost and number of full-time equivalents, and use this information to inform decisions about resource allocation and provider staffing. (Recommendation 1)

Agency: Indian Health Service
Status: Open

Comments: In February 2020, IHS reported that challenges in rolling-up contractor information on a national level stem from the fact that the agency often uses single contract vehicles, such as staffing companies, to hire multiple providers for temporary periods of time. IHS's contract databases do not centrally track the numbers of individual providers through such staffing contracts. The ability to analyze and compare detailed actual costs of federal hires vs. contract hires is currently limited to local information sources and on a narrow area of focus, such as one provider category or one facility at a time. IHS reported that the agency is implementing a monthly reporting requirement for IHS Areas and plans to use this information to inform decisions about resource allocation and provider staffing. We will review these reporting requirements when they have been fully implemented.