Beta This is a new resource - your feedback will help us improve it.
Recommendations Tracker
HHS-OIG provides independent and objective oversight that promotes economy, efficiency, and effectiveness in HHS programs and operations. To drive positive change, we produce reports and identify recommendations for improvement. We have developed this public-facing page for tracking all of our open recommendations. Learn More
Summary of Recommendations Data
Updated Monthly · Last updated on November 17, 2023
1,344
Open recommendations since start of FY 2000
$268.4B
Potential savings from open recommendations
2,369
Closed recommendations since start of FY 2018
Explore Open Recommendations
Showing 1–20 of 32 reports, containing 102 recommendations
Sorted by most recent report
-
Kentucky Experienced Challenges in Meeting Federal and State Foster Care Program Requirements During the COVID-19 Pandemic
- Audit
- A-06-22-07001
- HHS Agency
- ACF
- Issued
- 11/14/2023
- Report link
- View report
Recommendation text Responsible agency Potential savings We recommend that Kentucky conduct the name-based checks on the one applicant and one adolescent household member identified by our audit as lacking the required checks and reiterate to staff the importance of adhering to the policies and procedures requiring background checks to be completed before approving foster homes. ACF – We recommend that Kentucky identify ways to address the challenges related to meeting the requirements for conducting monthly caseworker visits, including consulting with ACF. ACF – We recommend that Kentucky conduct FBI fingerprint checks on the five applicants and other household members identified by our audit as lacking completed checks. ACF – -
Risk Assessment of the Administration for Children and Families' Purchase Card Program for Fiscal Year 2021
- Audit
- A-04-22-06262
- HHS Agency
- ACF
- Issued
- 09/08/2023
- Report link
- View report
Recommendation text Responsible agency Potential savings We recommend that ACF develop mitigating controls and strategies to lower the high and moderate risks we identified. ACF – -
Widespread Pandemic Disruption Spurred Innovation to State Paternity Establishment Practices
- Evaluation
- OEI-06-21-00150
- HHS Agency
- ACF
- Issued
- 08/28/2023
- Report link
- View report
Recommendation text Responsible agency Potential savings OCSS should bolster State agency resilience during emergencies. ACF – OCSS should create forums for identifying and sharing State agency best practices in providing paternity establishment services. ACF – -
Florida Did Not Comply With Requirements for Documenting Psychotropic and Opioid Medications Prescribed for Children in Foster Care
- Audit
- A-05-22-00009
- HHS Agency
- ACF
- Issued
- 07/14/2023
- Report link
- View report
Recommendation text Responsible agency Potential savings We recommend that the Florida Department of Children and Families coordinate with the Florida Agency for Health Care Administration to obtain access to Medicaid claim data for all children under its care and supervision. ACF – We recommend that the Florida Department of Children and Families provide training to CPIs and caseworkers on medication management and administration that addresses requirements for updating case records in FSFN for children who are prescribed psychotropic medications (including related medication logs and authorizations) and opioid medications. ACF – -
Alaska Experienced Challenges in Meeting Federal and State Foster Care Program Requirements During the COVID-19 Pandemic
- Audit
- A-06-21-07006
- HHS Agency
- ACF
- Issued
- 06/02/2023
- Report link
- View report
Recommendation text Responsible agency Potential savings We recommend that the Office of Children's Services continue to identify ways to address the challenges related to meeting the requirements for conducting monthly caseworker visits and home inspections, including consulting with ACF. ACF – We recommend that the Office of Children's Services ensure that staff are adequately trained on policies and procedures to ensure that required background checks are completed before placing children in foster homes under emergency conditions. ACF – We recommend that the Office of Children's Services complete home inspections in accordance with requirements for the two foster homes identified by our audit as lacking completed inspections and for the five foster homes requiring in-person inspections. ACF – -
The Office of Refugee Resettlement Needs To Improve Its Oversight Related to the Placement and Transfer of Unaccompanied Children
- Audit
- A-06-20-07002
- HHS Agency
- ACF
- Issued
- 05/23/2023
- Report link
- View report
Recommendation text Responsible agency Potential savings We recommend that the Office of Refugee Resettlement strengthen oversight of transfers between care provider facilities by requiring that all transfer documentation be maintained in the UC Portal and by developing procedures for tracking and reviewing that documentation. ACF – We recommend that the Office of Refugee Resettlement assess needs to expand the Office of Refugee Resettlement's network capacity to serve the needs of children with mental health and behavioral issues. ACF – We recommend that the Office of Refugee Resettlement review restrictive setting placement denials and take action as needed to ensure that, in the future when transfer is recommended, children will be able to obtain an appropriate placement. ACF – We recommend that the Office of Refugee Resettlement strengthen oversight of initial placements by addressing challenges with bed space capacity and intake specialist staffing during influx periods to ensure a placement is made within 24 hours of each referral and Intakes Placement Checklists are completed for children with special needs or concerns. ACF – -
State Agencies Can Improve Their Reporting of Children Missing From Foster Care to Law Enforcement for Entry Into the National Crime Information Center Database as Required by Federal Statute
- Audit
- A-07-21-06104
- HHS Agency
- ACF
- Issued
- 05/12/2023
- Report link
- Report pending
Recommendation text Responsible agency Potential savings We recommend that the Administration for Children and Families work with State agencies to ensure compliance with Federal requirements to report missing children episodes to law enforcement for entry into the NCIC database in a timely manner. ACF – -
The Office of Refugee Resettlement Needs To Improve Its Practices for Background Checks During Influxes
- Audit
- A-06-21-07003
- HHS Agency
- ACF
- Issued
- 05/02/2023
- Report link
- View report
Recommendation text Responsible agency Potential savings We recommend that the Office of Refugee Resettlement include a review of compliance by ICFs and EISs with all background check requirements and facility access as a part of ORR's routine site visit monitoring. ACF – -
Michigan Did Not Comply With Requirements for Documenting Psychotropic and Opioid Medications Prescribed for Children in Foster Care
- Audit
- A-05-21-00030
- HHS Agency
- ACF
- Issued
- 02/08/2023
- Report link
- View report
Recommendation text Responsible agency Potential savings We recommend that the Michigan Department of Health and Human Services ensure the electronic case records for children who are prescribed opioid medications are maintained in accordance with requirements by implementing procedures requiring caseworkers to monitor Medicaid claim data for opioid medications prescribed for the children and providing training to caseworkers on the requirements for documenting medications prescribed for the children in MiSACWIS, including opioid medications due to medical procedures or emergency treatments. ACF – We recommend that the Michigan Department of Health and Human Services ensure that electronic case records for the children under its care and supervision are maintained in accordance with State requirements by modifying procedures for the monitoring of caseworkers to include a review of medical passports in MiSACWIS. ACF – We recommend that the Michigan Department of Health and Human Services ensure the electronic case records for children who are prescribed psychotropic medications are maintained in accordance with requirements by implementing policies specific to non-emergency situations that require the FC-PMOU to document when consent forms do not need to be obtained; implementing procedures for caseworkers and the FC-PMOU to monitor the Medicaid claim data to ensure consent forms are obtained and documented; and implementing procedures requiring caseworkers and the FC-PMOU to monitor other medications prescribed for children, including opioids, for potential medication interaction and adverse side effects. ACF – -
Greater Bergen Community Action, Inc., Did Not Manage Its Head Start Awards in Accordance With Federal and State Requirements
- Audit
- A-02-19-02008
- HHS Agency
- ACF
- Issued
- 01/26/2023
- Report link
- View report
Recommendation text Responsible agency Potential savings Work with ACF to determine the amount of allowable vehicle costs or refund $92,678 to the Federal Government for potentially unallowable vehicle costs. ACF $92,678 Refund $394,733 to the Federal Government for unallowable costs charged to the Head Start awards. ACF $394,733 Strengthen its policies and procedures to ensure that grant drawdowns are used to cover immediate cash needs necessary for its Head Start expenditures; only allowable costs are charged to the Head Start program; vehicle usage costs are adequately supported; and background checks and health screenings are performed on all volunteers who provide more than 20 percent of services during GBCA's weekly operating hours. ACF – -
The Municipality of Manati Did Not Always Manage Its Head Start Disaster Assistance Awards in Accordance With Federal and Commonwealth Requirements
- Audit
- A-04-20-02032
- HHS Agency
- ACF
- Issued
- 12/21/2022
- Report link
- View report
Recommendation text Responsible agency Potential savings Develop and implement written policies and procedures to ensure that criminal background checks on employees are completed within required time frames. ACF – Work with ACF to develop a viable plan for refunding $153,052 in unallowable costs to the Federal Government. ACF $153,052 Develop and implement procurement policies and procedures to avoid acquiring unnecessary items and to perform analyses to determine the most reasonable approach for future vehicle purchases. ACF – -
ACF Should Improve Oversight of Head Start To Better Protect Children's Safety
- Evaluation
- OEI-BL-19-00560
- HHS Agency
- ACF
- Issued
- 09/23/2022
- Report link
- View report
Recommendation text Responsible agency Potential savings ACF should disseminate information about innovative practices that OHS regional offices have developed to better identify and prevent incidents that threaten children's safety. ACF – ACF should improve data-sharing with States about incidents of child abuse, lack of supervision, and unauthorized release in Head Start centers. ACF – ACF should improve Head Start grant recipients' self-reporting of incidents of child abuse, lack of supervision, and unauthorized release through better guidance and stronger consequences for failure to report. ACF – -
The Municipality of Barceloneta Did Not Always Manage Its Head Start Disaster Assistance Awards in Accordance With Federal and Commonwealth Requirements
- Audit
- A-02-20-02003
- HHS Agency
- ACF
- Issued
- 08/30/2022
- Report link
- View report
Recommendation text Responsible agency Potential savings We recommend that the Municipality of Barceloneta maintain complete and accurate accounting records and ensure that reconciliation of accounting records is conducted prior to the submission of Head Start program FFRs. ACF – We recommend that the Municipality of Barceloneta complete its integration of the Head Start program's accounting system to the Municipality's electronic accounting system. ACF – We recommend that the Municipality of Barceloneta reinforce existing policies and procedures to ensure that Head Start program bank reconciliations are completed in a timely manner. ACF – We recommend that the Municipality of Barceloneta reinforce existing policies and procedures to ensure that drawdowns for the Head Start program are based on a valid voucher. ACF – -
In Five States, There Was No Evidence That Many Children in Foster Care Had a Screening for Sex Trafficking When They Returned After Going Missing
- Evaluation
- OEI-07-19-00371
- HHS Agency
- ACF
- Issued
- 06/30/2022
- Report link
- View report
Recommendation text Responsible agency Potential savings ACF should encourage all States to evaluate the value of adding an assessment of risk for sex trafficking when children return to foster care after going missing. ACF – ACF should conduct oversight activities to identify States that may not screen all children for sex trafficking when they return to foster care after going missing. ACF – -
Louisiana’s Monitoring Did Not Ensure Child Care Provider Compliance With Criminal Background Check Requirements at 8 of 30 Providers Reviewed
- Audit
- A-06-19-02001
- HHS Agency
- ACF
- Issued
- 12/29/2021
- Report link
- View report
Recommendation text Responsible agency Potential savings We recommend that the Louisiana Department of Education ensure that providers initiate and complete criminal background checks for all required individuals, including those given access to children on a contingency basis. ACF – We recommend that the Louisiana Department of Education develop a process to ensure providers initiate required background checks for all employees in a timely manner. ACF – -
Case Study: Missouri’s Efforts To Protect Children Missing From Foster Care
- Evaluation
- OEI-07-19-00372
- HHS Agency
- ACF
- Issued
- 09/28/2021
- Report link
- View report
Recommendation text Responsible agency Potential savings ACF should support Missouri as it works to reduce children's risk for going missing from foster care and to improve compliance with Federal and State requirements related to children who go missing. ACF – Missouri foster care agency should develop policies to help identify (a) children who have a heightened risk of going missing from care and (b) interventions that could reduce their risk. ACF – Missouri foster care agency should implement a monitoring mechanism to ensure that case managers comply with requirements and document their compliance when children are identified as missing and when they are located or return to care. ACF – ACF should develop a forum for States to share experiences and best practices related to the following: reducing children's risk for going missing from foster care, locating missing children, and addressing their needs after they return to care. ACF – -
Gateway Community Action Partnership Claimed Unallowable Costs, Did Not Comply with Federal Regulations on Construction and Major Renovations, and Did Not Accurately Account for Grant Funds
- Audit
- A-02-18-02011
- HHS Agency
- ACF
- Issued
- 05/27/2021
- Report link
- View report
Recommendation text Responsible agency Potential savings We recommend that Gateway ensure that costs are allocated to Federal awards in accordance with the relative benefits received. ACF – We recommend that the Administration for Children and Families ensure that Gateway complies with Federal requirements and verify information submitted by Gateway to support Gateway’s grant award applications, including requesting Gateway to obtain independent analyses of cost comparisons for Head Start facility construction and major renovations. ACF – We recommend Gateway update and follow its procedures to ensure compliance with all Federal requirements and the accuracy of cost information, including cost proposals, submitted to ACF. Gateway did not comply with Federal requirements related to new construction and major renovations of its Head Start facilities. ACF – We recommend that Gateway refund $932,607 claimed in unallowable costs related to: (1) indirect costs ($356,121), (2) credits received from vendors ($338,363), (3) equipment that was not purchased in accordance with Federal open competition procurement regulations ($208,600), and (4) use of company vehicles ($29,523). ACF $932,907 -
New York Did Not Have Adequate Oversight of Its Reported Temporary Assistance for Needy Families Program Expenditures
- Audit
- A-02-17-02005
- HHS Agency
- ACF
- Issued
- 05/18/2021
- Report link
- View report
Recommendation text Responsible agency Potential savings We recommend that the New York State Office of Temporary and Disability Assistance work with its local districts and TANF-funded State programs to develop financial management procedures that would enable the State agency to determine if TANF and MOE expenditures are accurately reported to ACF, including the $4.8 billion in TANF and MOE expenditures reported for FY 2016. ACF – We recommend that the New York State Office of Temporary and Disability Assistance improve its oversight of the TANF program by providing additional guidance and training to ensure that its local districts accurately report expenditures and maintain adequate documentation to support TANF and MOE expenditures reported. ACF – -
ACF Cannot Ensure That All Child Victims of Abuse and Neglect Have Court Representation
- Evaluation
- OEI-12-16-00120
- HHS Agency
- ACF
- Issued
- 02/26/2021
- Report link
- View report
Recommendation text Responsible agency Potential savings ACF should conduct oversight activities to identify States that may not appoint a GAL to every child victim who undergoes a judicial proceeding, seeking statutory authority as necessary. ACF – ACF should proactively identify and address obstacles that States face in reporting complete and accurate GAL data. ACF – ACF should proactively provide technical assistance to States that face challenges in appointing a GAL for every child victim. ACF – -
Youth for Tomorrow – New Life Center, Inc., an Administration for Children and Families Grantee, Did Not Comply With All Applicable Federal Policies and Requirements
- Audit
- A-03-16-00250
- HHS Agency
- ACF
- Issued
- 09/29/2020
- Report link
- View report
Recommendation text Responsible agency Potential savings We recommend that Youth For Tomorrow – New Life Center, Inc. ensure that all employees follow policies and procedures requiring Federal and State background investigations to be completed before staff begin working with children, provide relevant training to appropriate staff, and document and maintain documentation of all results. ACF – We recommend that Youth For Tomorrow – New Life Center, Inc. develop policies and procedures for identifying allowable shared UAC program costs, including items that need advance approval, determine whether any of the $210,037 in potentially unallowable and $23,390 in potentially unallowable unapproved expenditures would be allowable under the newly approved allocation methodology or plan, and refund to the Federal Government any unallowable or unapproved portion. ACF – We recommend that Youth For Tomorrow – New Life Center, Inc. develop policies and procedures for identifying shared UAC program costs not in compliance with Federal requirements and refund $10,336 in unallowable employee appreciation expenditures. ACF $10,336 We recommend that Youth For Tomorrow – New Life Center, Inc. develop policies and procedures for claiming indirect expenditures based on the approved indirect cost rate. ACF – We recommend that Youth For Tomorrow – New Life Center, Inc. work with ORR to determine an allocation methodology or plan to claim shared direct expenditures in proportion to benefits received, develop a policy to reflect this methodology or plan, determine whether any of the $1,352,027 in direct expenditures and up to $235,253 in related indirect expenditures allocated using the unreasonable allocation ratio was allowable, and refund to the Federal Government any unallowable portion. ACF – We recommend that Youth For Tomorrow – New Life Center, Inc. strengthen existing procedures to ensure that family reunification packets are sent within required timeframes. ACF – We recommend that Youth For Tomorrow – New Life Center, Inc. develop policies and procedures for identifying direct UAC program costs not in compliance with Federal requirements and refund $6,515 in unallowable expenditures not related to the UAC program. ACF $6,515 We recommend that Youth For Tomorrow – New Life Center, Inc. develop policies and procedures for promptly notifying DHS of the imminent release of a child to a sponsor and document and maintain all correspondence. ACF – We recommend that Youth For Tomorrow – New Life Center, Inc. work with ORR to develop allowable methodologies to allocate salaries, develop a procedure or system to capture what programs each employee actually worked on, and determine what portion of the $1,500,218 in salaries charged based on budget estimates was accurately charged to the UAC program and refund to the Federal Government any unallowable portion. ACF – We recommend that Youth For Tomorrow – New Life Center, Inc. ensure that all case file documents are accurately timestamped to the date they are actually completed and that all staff are trained on how to properly maintain accurate and up-to-date case files. ACF – We recommend that Youth For Tomorrow – New Life Center, Inc. implement procedures and controls for collecting and reconciling information contained in its performance reports by developing protocols for collecting required data, handling system failures, and resolving discrepancies to ensure that all performance reports are accurate, verifiable, and reviewed before release to ORR. ACF –