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As of January 31, 2023, there are 4839 open recommendations that still need to be addressed. 470 of these are priority recommendations, those that we believe warrant priority attention. Learn more about our priority designation on our Recommendations page.

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1 - 8 of 8 Recommendations, including 0 Priority Recommendations

Tribal Epidemiology Centers: HHS Actions Needed to Enhance Data Access

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2 Open Recommendations
Agency Recommendation Status
Indian Health Service The Director of IHS should develop written guidance for TECs on how to request data. Such guidance should include information on the data available to TECs, how to request data, agency contacts, criteria the agency will use to review such requests, and time frames for receiving an agency response to data requests. (Recommendation 4)
Open

HHS agreed with our recommendation. As of September 2022, IHS has begun developing a policy for sharing data with TECs. In developing a policy, IHS reported assessing its current data sharing practices with TECs and gathering input from TEC leaders. IHS also reported that it plans to seek input from a variety of IHS officials and tribal leaders, including through a tribal consultation process. IHS anticipated completing its guidance for TECs on how to request data by April 2023. To fully implement this recommendation, IHS must develop written guidance for TECs on how to request data.

Indian Health Service The Director of IHS should develop and document agency procedures on reviewing TEC requests for and making data available to TECs. These procedures should include a description of the data available to TECs, agency contacts, criteria for reviewing TEC data requests, and time frames for responding to TEC requests. (Recommendation 5)
Open

HHS agreed with our recommendation. As of September 2022, IHS has begun developing a policy for sharing data with TECs. In developing a revised policy, IHS reported assessing its current data sharing practices with TECs and gathering input from TEC leaders. IHS also reported that it plans to seek input from a variety of IHS officials and tribal leaders, including through a tribal consultation process. IHS anticipated completing its development of agency procedures for reviewing to TEC data requests by April 2023. To fully implement this recommendation, IHS must develop agency procedures on

Indian Health Service: Actions Needed to Improve Oversight of Provider Misconduct and Substandard Performance

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1 Open Recommendations
Agency Recommendation Status
Indian Health Service The Director of IHS headquarters should establish a standard approach or tool to ensure that governing boards consistently document their review of information related to provider misconduct and substandard performance. (Recommendation 3)
Open

IHS is working to establish a standard approach or tool to ensure that governing boards consistently document their review of information related to provider misconduct and substandard performance, as we recommended in December 2020. In May 2021, IHS told us that the IHS Director will issue a policy directive to all area offices that will include guidance on including provider misconduct reports in each Governing Board meeting. The policy directive will also require governing boards to notify the IHS Quality Assurance Risk Management Committee of major high-risk incidents. In June 2022, IHS

Indian Health Service: Actions Needed to Improve Oversight of Federal Facilities' Decision-Making About the Use of Funds

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2 Open Recommendations
Agency Recommendation Status
Indian Health Service The Director of IHS should develop a process to ensure that IHS area offices systematically assess how the scope of services provided by federally operated health care facilities will effectively meet the current and future needs of their patient populations, which could include the incorporation of a current community health needs assessment. (Recommendation 1)
Open

IHS agreed with our recommendation. As of June 2022, IHS told us that it is working to establish a reporting process to verify that community needs are assessed at least annually. IHS also reported that it had that it had obtained area office feedback on current processes to assess patient population needs. To fully implement this recommendation, IHS must complete the development and implementation of a process to systematically assess patient population needs and establish a process to review these needs along with the scope of services provided by federally operated health care facilities.

Indian Health Service The Director of IHS should develop a process to guide IHS area offices' review of federally operated health care facilities' spending proposals, both before approval and after they are implemented, and ensure this process is followed. (Recommendation 2)
Open

IHS agreed with our recommendation. As of June 2022, IHS reported that it created a new dashboard to provide the agency with more comprehensive financial data at a more granular level. IHS also reporting that it has plans to convene financial management staff to discuss this recommendation, conduct a root cause analysis, develop system maps of financial processes, and review, design, and document processes for funding decisions at IHS operated health care facilities. To fully implement this recommendation, IHS should develop and implement a process to guide area offices' review of facilities'

Cybersecurity: DHS and Selected Agencies Need to Address Shortcomings in Implementation of Network Monitoring Program

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2 Open Recommendations
Agency Recommendation Status
Indian Health Service The Director of IHS should document approved hardware inventory information by associating FISMA systems with the hardware on its network in a format that can be readily integrated into its CDM tools. (Recommendation 10)
Open

As of September 2022, the Indian Health Service has not provided sufficient evidence to close this recommendation. When we confirm what actions IHS has taken we will provide updated information.

Indian Health Service The Director of IHS should configure its CDM tools to compare configuration settings against federal core benchmarks applicable to its environment. (Recommendation 12)
Open

As of September 2022, the Indian Health Service has not provided sufficient evidence to close this recommendation. When we confirm what actions IHS has taken we will provide updated information.

VA and Indian Health Service: Actions Needed to Strengthen Oversight and Coordination of Health Care for American Indian and Alaska Native Veterans

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1 Open Recommendations
Agency Recommendation Status
Indian Health Service 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)
Open

IHS concurred with this recommendation. In December 2021, IHS reported that effective, October 1, 2021, VA and IHS executed a new MOU. The agency reported that IHS and VA will continue working together to develop an annual operation plan to ensure that performance measures include appropriate measurable targets. In February 2022, VA reported that that the draft operational plan was completed on January 30, 2022, and was under review by IHS and VA's Veterans Health Administration (VHA), with a focus on performance targets and measures. VA reported that, once internal review was complete, the

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For questions about a specific recommendation, contact the person or office listed with the recommendation. For general information about recommendations, contact GAO's Audit Policy and Quality Assurance office at (202) 512-6100 or apqa@gao.gov.