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Audit of the Background Verification Process of Commissioned Corps Officers Assigned to Tribal and Indian Health Service Health Programs

Announced on  | Last Modified on  | Project Number: A-01-24-01500
Status
Completed
Agency
Indian Health Service

OBJECTIVE

The United States Public Health Service Commissioned Corps is a branch of the Nation's uniformed services committed to the service of public health. Commissioned Corps Officers (CCOs) advance the Nation's public health by serving in agencies across the Government as physicians, nurses, dentists, scientists, engineers, and other professionals to fight disease, conduct research, and care for patients in underserved communities across the Nation and throughout the world. CCOs may be assigned to the Indian Health Service (IHS), which can place a CCO at Tribal or IHS health programs. The Indian Child Protection and Family Violence Prevention Act (P.L. No. 101-630) requires background investigations, including Federal Bureau of Investigation fingerprinting, for individuals whose duties involve contact with children. Federal regulations require periodic reinvestigations of CCOs. Prior OIG audit work identified that Federal employees assigned to Tribal and IHS health programs did not always meet Federal background investigation requirements for individuals in contact with American Indian children. We will determine whether CCOs assigned to provide health care services to Tribal and IHS health programs received background investigations and reinvestigations in accordance with Federal requirements.

TIMELINE

  • October 23, 2023
    Announced
  • December 9, 2025
    Complete

    Audit of the Background Verification Process of Commissioned Corps Officers Assigned to Tribal and Indian Health Service Health Programs has been marked as complete. This audit resulted in 10 recommendations.

REPORT PUBLISHED

The Indian Health Service Did Not Ensure That Commissioned Corps Officers’ Background Investigations Complied With Federal Requirements (A-01-24-01500)

Officers assigned to provide health care services to Tribal and IHS-operated health programs did not receive background investigations in accordance with Federal requirements. We found that:

  • IHS did not ensure that the background investigations for any of the 100 Officers in our sample considered the minimum character standard requirements of the ICPFVPA.
  • IHS did not provide evidence for 59 Officers in our sample with pending background investigations that the Officers were within the sight and under the supervision of staff members with satisfactory background investigations or communicated to Tribes that the Officers had pending background investigations and required supervision when children are in their care.
  • IHS did not ensure that background investigations for 39 Officers in our sample that needed reinvestigations were initiated within the standard timeframe.

Commissioned Corps and IHS relied on the Office of National Security (ONS) adjudicated background investigations, but they were not aware that these background investigations were based on Federal guidelines that did not assess an individual’s criminal history results against the minimum character standards of the ICPFVPA.

26-A-01-022.01 to IHS - Open Unimplemented
Update expected on 06/08/2026
We recommend that the Indian Health Service work with the Office of National Security to develop policies and procedures to ensure that all Officers assigned to IHS have background investigations adjudicated according to the requirements of the ICPFVPA.

26-A-01-022.02 to IHS - Open Unimplemented
Update expected on 06/08/2026
We recommend that the Indian Health Service work with ONS to evaluate the most recent background investigation results for all Officers assigned to IHS and determine whether the individuals meet the minimum character standards of the ICPFVPA to allow the individuals to be in contact with Indian children.

26-A-01-022.03 to IHS - Open Unimplemented
Update expected on 06/08/2026
We recommend that the Indian Health Service determine which Officers have pending background investigations and take immediate action to ensure the supervision of these individuals when children are in their care.

26-A-01-022.04 to IHS - Open Unimplemented
Update expected on 06/08/2026
We recommend that the Indian Health Service develop policies and procedures to communicate provisional clearance status of Officers assigned to Tribal health programs to Tribes.

26-A-01-022.05 to IHS - Open Unimplemented
Update expected on 06/08/2026
We recommend that the Indian Health Service work with ONS to obtain full access to all Officers' background investigation data in the Security Manager system that includes criminal history results to enable a determination of the schedule for reinvestigations.

26-A-01-022.06 to IHS - Open Unimplemented
Update expected on 06/08/2026
We recommend that the Indian Health Service develop and implement policies and procedures to identify and track when Officers background reinvestigations will expire and initiate reinvestigations within the standard timeframe.

26-A-01-022.07 to OASH - Open Unimplemented
Update expected on 06/08/2026
We recommend that the Commissioned Corps of the United States Public Health Service work with the Office of National Security to develop policies and procedures to ensure that all Officers assigned to IHS have background investigations adjudicated according to the requirements of the ICPFVPA.

26-A-01-022.08 to OASH - Open Unimplemented
Update expected on 06/08/2026
We recommend that the Commissioned Corps of the United States Public Health Service communicate an Officer's provisional clearance status at the time the individual is assigned to a Division and the final determination of the background investigation adjudication to Divisions.

26-A-01-022.09 to OASH - Open Unimplemented
Update expected on 06/08/2026
We recommend that the Commissioned Corps of the United States Public Health Service maintain documentation of provisional clearance status and final determination of background investigations in Officers' eOPFs to facilitate use of the Officers' personnel records in the redetermination of their eligibility for a position.

26-A-01-022.10 to OASH - Open Unimplemented
Update expected on 06/08/2026
We recommend that the Commissioned Corps of the United States Public Health Service collect at least annually, background investigations that have been adjudicated and enter the COIs into the Officers' eOPF.

View in Recommendation Tracker
Work Plan Type
Office of Audit Services
HHS Agencies
Indian Health Service
Issue Areas
Physician and Healthcare Practitioners Quality of Care
Target Groups
Children and Families
Financial Groups
Other Funding