IHS slow to resolve audit recommendations under Grim

Thursday, July 26, 2007  

The Indian Health Service has been slow to resolve deficiencies under the leadership of Dr. Charles Grim, according to a recent audit.

Of more than 6,600 pending audit recommendations, 94 percent were past due for resolution, the Inspector General of the Department of Health and Human Services said. And of the issues that were addressed, the majority weren't resolved within the required six-month period.

"As a result, IHS did not have reasonable assurance that it was exercising proper stewardship over federal dollars," Joseph E. Vengrin, a deputy inspector general, said in a memo to Grim.

The memo was dated March 9. Two months later, President Bush nominated Grim, a member of the Cherokee Nation of Oklahoma, to second term as the leader of the agency responsible for delivering health care to nearly two million American Indians and Alaska Natives.

Grim goes before the Senate Indian Affairs Committee for his confirmation hearing on Thursday. With the exception of three major issues -- the Indian Health Improvement Act reauthorization, self-determination contracts and construction of new clinics and hospitals -- he has received mainly favorable reviews from Congress and Indian Country.

The Inspector General audit paints a slightly different picture. It covers the years 2003 through 2005 -- the years of Grim's first term as director of the IHS.

According to the audit, IHS received 9,493 audit recommendations by December 2005. But only 2,840 were resolved during this period, the report said.

White House policy requires agencies to resolve audit recommendations within six months. Yet only 4 percent of 2,840 recommendations were resolved in a timely fashion.

That leaves 6,653 pending audit recommendations. Of those, 94 percent are past the required six-month time period -- with some even past due for four to five years, according to the audit.

"Based on the backlog of outstanding audit recommendations, we are also concerned that IHS will not resolve future recommendations in a timely manner," Vengrin wrote.

In a response, Grim concurred with the report's findings. He said he has created a new audit division to address the long-overdue recommendations.

On a separate issue, the Inspector General recently released a series of reports detailing the lack of security of prescription drugs at five IHS facilities. Drugs weren't always kept locked down and some facilities didn't have alarms as required by federal regulations, the reports said.

At one facility -- the Lawton Indian Hospital in Oklahoma -- a dentist admitted to stealing painkillers. "These deficiencies occurred because Lawton officials did not enforce applicable policies and procedures," one report said.

The Inspector General recommended IHS to direct the facilities -- which included the Indian Health Center in Anadarko, Oklahoma; the W.W. Hastings Indian Hospital in Tahlequah, Oklahoma; the Santa Fe Indian Hospital in New Mexico; and the Indian Health Center in Santo Domingo Pueblo, New Mexico -- to ensure they are following security standards.

In response, Grim said the facilities were taking steps to implement the audit recommendations.

Inspector General Reports:
Indian Health Service’s Resolution of Audit Recommendations | Safeguards Over Controlled Substances at Lawton Indian Hospital | Safeguards Over Controlled Substances at Santa Fe Indian Hospital | Safeguards Over Controlled Substances at Anadarko Indian Health Center | Safeguards Over Controlled Substances at Santo Domingo Indian Health Center | Safeguards Over Controlled Substances at W.W. Hastings Indian Hospital

Relevant Links:
Indian Health Service - http://www.ihs.gov