Gallup Indian Medical Center—an IHS-Operated Health Facility—Did Not Timely Conduct Required Background Checks of Staff and Supervise Certain Staff

Why OIG Did This Audit

• The Indian Child Protection and Family Violence Act established requirements for Federal background investigations for individuals in contact with Indian children as well as supervision of such individuals pending completion of the background investigation. Prior OIG work in this area found noncompliance with these requirements.
• This audit assessed whether Gallup Indian Medical Center (the Hospital), an IHS-operated health facility in Gallup, New Mexico overseen by the IHS Navajo Area Office, met Federal requirements for conducting background investigations and supervision of staff in contact with Indian children.

What OIG Found

• For 45 of the 50 staff members we reviewed, the Hospital did not comply with Federal requirements for conducting background investigations of staff in contact with Indian children, including failing to initiate or timely initiate and adjudicate certain investigations.
• For the 50 staff members, the Hospital did not document supervision for 44 staff members with pending background investigations (provisional staff) in accordance with Federal requirements.
• Navajo Area Office officials stated that they were unable to explain the cause of many of the deficiencies because they were not employed at the Hospital when the deficiencies occurred. However, we determined that the deficiencies generally occurred because the Hospital did not monitor compliance with background check requirements for permanent staff and its procedures do not include completing background investigations on temporary staff or documenting compliance with supervision requirements.
• As a result of these deficiencies, Indian children faced an increased risk of harm and abuse.

What OIG Recommends

We made a series of five recommendations to IHS, including that it work with the Hospital and the Navajo Area Office to complete background investigations for staff members identified in our report, adequately document provisional staff supervision, and update standard operating procedures for background investigations. The full recommendations are in the report.

IHS concurred with four of our recommendations and partially concurred with one recommendation. IHS also detailed steps it has taken and plans to take to address them.