Recommendations Tracker
HHS-OIG provides independent and objective oversight that promotes economy, efficiency, and effectiveness in HHS programs and operations. To drive this positive change, we produce reports and identify recommendations for improvement. We have developed this public-facing page for tracking all of our open recommendations.
Use the Top Unimplemented View below to read OIG's Top Unimplemented Recommendations. In OIG’s view, these top recommendations for HHS programs, if implemented, would have the greatest impact in terms of cost savings, program effectiveness and efficiency, and public health and safety. Learn more
Summary of All Recommendations
Updated Monthly · Last updated on November 14, 2025
1,188
Unimplemented
recommendations
3,135
Implemented and Closed
recommendations since FY 2017
Views
OIG Recommendations Grouped by Report
Showing 1–1 of 1 reports, containing 11 recommendations
Sorted by latest release date
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Two Tribes in Oklahoma and Their Health Programs Did Not Meet All Federal and Tribal Requirements for Background Investigations on Individuals in Contact With Indian Children
24-A-01-039.01We recommend that the Choctaw Nation perform background investigations, as required by the ICPFVPA, on all employees and temporary employees who currently have contact with Indian children and determine whether these individuals meet the required minimum character standards.- Status
- Open Unimplemented
- Responsible Agency
- IHS
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 07/11/2024
- Legislative Related
- No
24-A-01-039.02We recommend that the Choctaw Nation request and review agency contractor background investigations that comply with the ICPFVPA, including documentation that confirms HHS employees met all background investigation requirements of the ICPFVPA, or perform background investigations on these individuals that comply with the ICPFVPA.- Status
- Open Unimplemented
- Responsible Agency
- IHS
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 07/11/2024
- Legislative Related
- No
24-A-01-039.03We recommend that the Choctaw Nation develop and implement policies and procedures that ensure that the Tribe follows the requirements of the ICPFVPA to: collect information about the applicants' previous 5 years of residency, conduct FBI fingerprint background investigations using FBI-approved procedures for all individuals in contact with Indian children, conduct inquiries to State and Tribal law enforcement agencies about the applicants' previous 5 years of residency, and assess criminal history results to verify that applicants meet the required minimum character standards.- Status
- Open Unimplemented
- Responsible Agency
- IHS
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 07/11/2024
- Legislative Related
- No
24-A-01-039.04We recommend that the Cherokee Nation perform background investigations, as required by the ICPFVPA, on the employees and volunteers we identified as not having complete background investigations who currently have contact with Indian children and determine whether these individuals meet the required minimum character standards.- Status
- Open Unimplemented
- Responsible Agency
- IHS
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 07/11/2024
- Legislative Related
- No
24-A-01-039.05We recommend that the Cherokee Nation identify employees and volunteers outside our sample who lack evidence that a background investigation was performed, as required by the ICPFVPA, and who currently have contact with Indian children and perform the required background investigation and determine whether these individuals meet the required minimum character standards.- Status
- Open Unimplemented
- Responsible Agency
- IHS
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 07/11/2024
- Legislative Related
- No
24-A-01-039.06We recommend that the Cherokee Nation request and review agency contractor background investigations that comply with the ICPFVPA, including documentation that confirms HHS employees met all background investigation requirements of the ICPFVPA, or perform background investigations on these individuals that comply with the ICPFVPA.- Status
- Open Unimplemented
- Responsible Agency
- IHS
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 07/11/2024
- Legislative Related
- No
24-A-01-039.07We recommend that the Cherokee Nation develop and implement policies and procedures to ensure that: all individuals, including contractors and volunteers, in contact with Indian children are fingerprinted prior to starting employment, illegible fingerprints are retaken and resubmitted to FBI until a background investigation is completed in accordance with the requirements of the ICPFVPA, background investigations of contractors, including HHS employees, are reviewed or performed as required by the ICPFVPA and Tribal policies, and criminal history results are assessed to verify that applicants meet the required minimum character standards.- Status
- Open Unimplemented
- Responsible Agency
- IHS
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 07/11/2024
- Legislative Related
- No
24-A-01-039.08We recommend that the Indian Health Service enhance Single Audit Compliance Supplement, part 4: "Agency Program Requirements," for Tribes receiving ISDEAA funds from IHS by: establishing special tests and audit procedures in the annual Single Audit Compliance Supplement for all its ISDEAA programs to ensure that the ICPFVPA's requirements are tested during a review of a Tribal health program as part of the single audit, and reviewing the results of those special tests and audit procedures in the annual single audits for Tribal health programs to help assess whether Tribes are complying with ICPFVPA requirements to conduct background investigations and meet minimum standards of character.- Status
- Closed Implemented
- Responsible Agency
- IHS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/27/2025
- Legislative Related
- No
24-A-01-039.09We recommend that the Indian Health Service develop and offer a nationwide training seminar to Tribes on background investigation requirements of the ICPFVPA.- Status
- Open Unimplemented
- Responsible Agency
- IHS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/19/2025
- Next Update Expected
- 09/19/2025
- Legislative Related
- No
24-A-01-039.10We recommend that the Indian Health Service provide Tribes with documentation that confirms that current HHS employees assigned to Tribal health programs met all background investigation requirements of the ICPFVPA.- Status
- Open Unimplemented
- Responsible Agency
- IHS
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 07/11/2024
- Legislative Related
- No
24-A-01-039.11We recommend that the Indian Health Service develop policies and procedures to communicate to Tribes that HHS employees assigned to Tribal health programs met the background investigation requirements of the ICPFVPA and inform Tribes that Federal background investigation criminal history results may not cover more stringent character standards that Tribes may adopt as allowed by the ICPFVPA.- Status
- Open Unimplemented
- Responsible Agency
- IHS
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 07/11/2024
- Legislative Related
- No