HHS challenges: Better infection control, management of public health grants

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HHS headquarters.

Two of the big challenges that the U.S. Department of Health and Human Services faces in 2017, according to the Office of Inspector General, are better infection control and improved oversight of how to spend grant funds for public programs.

The OIG issued a report last week that focused on seven different challenges facing the HHS. Among them were threats to the Medicare Part A and Part B trust funds.

But the HHS' watchdog arm also mentioned other significant challenges the department faces. Among the biggest is proper infection control for vulnerable populations, such as residents of nursing and hospice facilities.

“Problems continue with the quality of care and safety of people in nursing facilities, as well as concerns related to preventing abuse of nursing facility residents, that particular section of the report said. “For example, in a review of a nursing home's residents who were hospitalized with urinary tract infections, we found that providers did not always render services to residents in accordance with their care plans before the residents were hospitalized with urinary tract infections.”

A report released earlier this year by the Leapfrog Group concluded that many hospitals are falling short on infection control measures.

Regarding the use of funds for public health programs, the OIG noted that HHS is the biggest grant-making body in the federal government, awarding more than $400 billion during the current fiscal year. But that money is often at risk for being deliberately misdirected.

“Misuse of federal funds poses significant risks to the integrity of HHS programs,” the report said. For example, the OIG found that “the Centers for Disease Control and Prevention did not always adequately document its funding decisions to award $1.9 billion in President's Emergency Plan for AIDS Relief funds over a five-year project period,” the report concluded. “OIG also found that CDC may have considered applications that it should not have or treated applicants inconsistently.”

There have been some other more obvious misuses of funds: The OIG concluded last month that HHS paid nearly $35 million in improper Medicare payments for the care of incarcerated patients.

Although the OIG has concluded that the HHS has improved its program integrity efforts, it said the agency “needs to take more aggressive action to identify poorly performing grantees and those at risk of misspending federal dollars and either provide increased technical assistance and monitoring or prevent them from continuing to receive grant funds.”