Indian Health Service
Mismanagement Led to Millions of Dollars in Lost or Stolen Property and Wasteful Spending Gao ID: GAO-08-1069T July 31, 2008In June 2007, GAO received information from a whistleblower through GAO's FraudNET hotline alleging millions of dollars in lost and stolen property and gross mismanagement of property at Indian Health Service (IHS), an operating division of the Department of Health and Human Services (HHS). GAO was asked to conduct a forensic audit and related investigations to (1) determine whether GAO could substantiate the allegation of lost and stolen property at IHS and identify examples of wasteful purchases and (2) identify the key causes of any loss, theft, or waste. GAO analyzed IHS property records from fiscal years 2004 to 2007, conducted a full physical inventory at IHS headquarters, and statistically tested inventory of information technology (IT) equipment at seven IHS field locations in 2007 and 2008. GAO also examined IHS policies, conducted interviews with IHS officials, and assessed the security of property.
Millions of dollars worth of IHS property has been lost or stolen over the past several years. Specifically: IHS identified over 5,000 lost or stolen property items, worth about $15.8 million, from fiscal years 2004 through 2007. These missing items included all-terrain vehicles and tractors; Jaws of Life equipment; and a computer containing sensitive data, including social security numbers. GAO's physical inventory identified that over 1,100 IT items, worth about $2 million, were missing from IHS headquarters. These items represented about 36 percent of all IT equipment on the books at headquarters in 2007 and included laptops and digital cameras. Further, IHS staff attempted to obstruct GAO's investigation by fabricating hundreds of documents. GAO also estimates that IHS had about 1,200 missing IT equipment items at seven field office locations worth approximately $2.6 million. This represented about 17 percent of all IT equipment at these locations. However, the dollar value of lost or stolen items and the extent of compromised data are unknown because IHS does not consistently document lost or stolen property, and GAO only tested a limited number of IHS locations. Information related to cases where GAO identified fabrication of documents and potential release of sensitive data was referred to the HHS Inspector General for further investigation. GAO identified that the loss, theft, and waste can be attributed to IHS's weak internal control environment. IHS management has failed to establish a strong "tone at the top," allowing property management problems to continue for more than a decade with little or no improvement or accountability for lost and stolen property and compromise of sensitive personal data. In addition, IHS has not effectively implemented numerous property policies, including the proper safeguards for its expensive IT equipment. For example, IHS disposed of over $700,000 worth of equipment because it was "infested with bat dung."
GAO-08-1069T, Indian Health Service: Mismanagement Led to Millions of Dollars in Lost or Stolen Property and Wasteful Spending
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Testimony:
Before the Committee on Indian Affairs, U.S. Senate:
United States Government Accountability Office:
GAO:
For Release on Delivery Expected at 9:30 a.m. EDT:
Thursday, July 31, 2008:
Indian Health Service:
Mismanagement Led to Millions of Dollars in Lost or Stolen Property and
Wasteful Spending:
Statement of Gregory D. Kutz, Managing Director Forensic Audits and
Special Investigations:
GAO-08-1069T:
GAO Highlights:
Highlights of GAO-08-1069T, a testimony before the Committee on Indian
Affairs, U.S. Senate.
Why GAO Did This Study:
In June 2007, GAO received information from a whistleblower through
GAO‘s FraudNET hotline alleging millions of dollars in lost and stolen
property and gross mismanagement of property at Indian Health Service
(IHS), an operating division of the Department of Health and Human
Services (HHS). GAO was asked to conduct a forensic audit and related
investigations to (1) determine whether GAO could substantiate the
allegation of lost and stolen property at IHS and identify examples of
wasteful purchases and (2) identify the key causes of any loss, theft,
or waste.
GAO analyzed IHS property records from fiscal years 2004 to 2007,
conducted a full physical inventory at IHS headquarters, and
statistically tested inventory of information technology (IT) equipment
at seven IHS field locations in 2007 and 2008. GAO also examined IHS
policies, conducted interviews with IHS officials, and assessed the
security of property
What GAO Found:
Millions of dollars worth of IHS property has been lost or stolen over
the past several years. Specifically:
* IHS identified over 5,000 lost or stolen property items, worth about
$15.8 million, from fiscal years 2004 through 2007. These missing items
included all-terrain vehicles and tractors; Jaws of Life equipment; and
a computer containing sensitive data, including social security
numbers.
* GAO‘s physical inventory identified that over 1,100 IT items, worth
about $2 million, were missing from IHS headquarters. These items
represented about 36 percent of all IT equipment on the books at
headquarters in 2007 and included laptops and digital cameras. Further,
IHS staff attempted to obstruct GAO‘s investigation by fabricating
hundreds of documents.
* GAO also estimates that IHS had about 1,200 missing IT equipment
items at seven field office locations worth approximately $2.6 million.
This represented about 17 percent of all IT equipment at these
locations.
However, the dollar value of lost or stolen items and the extent of
compromised data are unknown because IHS does not consistently document
lost or stolen property, and GAO only tested a limited number of IHS
locations. Information related to cases where GAO identified
fabrication of documents and potential release of sensitive data was
referred to the HHS Inspector General for further investigation.
The figure shows examples of the lost and stolen property GAO
identified during the audit.
Figure: Examples of Lost and Stolen Property Identified at IHS:
This figure is a combination of illustrations showing examples of lost
and stolen property identified at IHS.
Caterpillar tractor;
All-terrain vehicle;
Pickup truck;
Jaws of life;
Laptop;
Digital camera.
[See PDF for image]
Source: GAO, Art Explosion.
[End of figure]
GAO also found evidence of wasteful spending, including identifying
that there are about 10 pieces of IT equipment for every one employee
at headquarters. GAO‘s investigation also found computers and other IT
equipment were often assigned to vacant offices.
GAO identified that the loss, theft, and waste can be attributed to
IHS‘s weak internal control environment. IHS management has failed to
establish a strong ’tone at the top,“ allowing property management
problems to continue for more than a decade with little or no
improvement or accountability for lost and stolen property and
compromise of sensitive personal data. In addition, IHS has not
effectively implemented numerous property policies, including the
proper safeguards for its expensive IT equipment. For example, IHS
disposed of over $700,000 worth of equipment because it was ’infested
with bat dung.“
What GAO Recommends:
In the report (GAO-08-727), on which this testimony was based, GAO made
10 recommendations to IHS to update its policy and enforce management
policies. HHS agreed to 9 recommendations but did not agree to
establish procedures to track all sensitive equipment if they fall
under the accountable dollar threshold criteria. GAO disagreed with
HHS‘s assessment and reiterated support for all recommendations.
To view the full product, including the scope and methodology, click on
[http://www.gao.gov/cgi-bin/getrpt?GAO-08-1069T]. For more information,
contact Gregory Kutz at (202) 512-6722 or kutzg@gao.gov.
[End of section]
Mr. Chairman and Members of the Committee:
Thank you for the opportunity to discuss the results of our
investigation of lost or stolen property at the Indian Health Service
(IHS). In June 2007, we received information from a whistleblower
through GAO's FraudNET hotline alleging gross mismanagement of property
at IHS and wasteful spending. Specifically, the whistleblower, who was
a cognizant property official, alleged that IHS could not locate 1,180
pieces of accountable personal property valued at over $1.8 million.
The lost or stolen equipment included computers and other potentially
sensitive information technology (IT) equipment at IHS headquarters.
The whistleblower also claimed that officials at IHS headquarters wrote
off millions of dollars worth of missing inventory without holding
anyone financially liable. Based on the significance of these claims,
we conducted an investigation to determine whether the whistleblower's
allegations were valid. We described the results of the investigation
in a recent report that was issued last month.[Footnote 1]
Today, our testimony will summarize the results of our investigation
and will describe the (1) substantiation of the allegation of lost or
stolen property at IHS, (2) identification of examples of wasteful
purchases and (3) identification of the key causes of any loss, theft,
or waste that we detected.
As detailed in our recent report, to substantiate the allegation of
lost or stolen property at IHS, we analyzed IHS property documents that
identified lost or stolen property from fiscal year 2004 through fiscal
year 2007. We conducted a full physical inventory of property at IHS
headquarters[Footnote 2] and performed random sample testing of IT
equipment inventory at seven IHS field locations[Footnote 3] that we
selected based on book value of inventory and geographic
proximity.[Footnote 4] We did not attempt to quantify the level of
waste at IHS, but we identified instances of waste through observations
during our equipment inventories at headquarters and random sample
testing at the selected field locations. Although we did not perform a
systematic review of IHS internal controls, we identified the key
causes of lost and stolen property and waste by examining IHS policies
and procedures, conducting interviews with IHS officials, and assessing
the physical security of property through our inventory testing.
We conducted this forensic audit and related investigations from
September 2007 to June 2008 in accordance with generally accepted
government auditing standards.[Footnote 5] Those standards require that
we plan and perform the audit to obtain sufficient, appropriate
evidence to provide a reasonable basis for our findings and conclusions
based on our audit objectives. Despite IHS efforts to obstruct our
audit by making misrepresentations and fabricating hundreds of
documents, we were still able to accomplish our objectives. We believe
that the evidence obtained provides a reasonable basis for our findings
and conclusions based on our audit objectives. We performed our
investigative work in accordance with standards prescribed by the
President's Council on Integrity and Efficiency.
Summary:
We confirmed the whistleblower's allegation of gross mismanagement of
property at IHS. Specifically, we found that thousands of computers and
other property, worth millions of dollars[Footnote 6], have been lost
or stolen at IHS over the past several years. The number and dollar
value of items that have been lost or stolen since 2004 is likely much
higher because IHS did not consistently document lost or stolen
property items. In addition, IHS did not provide us all the requested
reports that IHS field offices used to document lost or stolen property
since fiscal year 2004.
IHS's ineffective management over IT equipment has also led to wasteful
spending. Our analysis of IHS records indicates that there are
approximately 10 pieces of IT equipment for every one employee at IHS
headquarters.[Footnote 7] We also found numerous pieces of recent-model
excess equipment at IHS headquarters, including 25 brand new computers-
-valued at a combined total of about $30,000--that were not issued to
any employees and were collecting dust in a store room.
The lost or stolen property and waste we detected at IHS can be
attributed to the agency's weak internal control environment and its
ineffective implementation of numerous property policies. IHS
management has failed to establish a strong "tone at the top" by
allowing inadequate accountability over property to persist for years
and by neglecting to fully investigate cases related to lost and stolen
items. Moreover, we found that IHS did not (1) conduct annual
inventories of accountable property; (2) use receiving agents for
acquired property at each location and designate property custodial
officers in writing to be responsible for the proper use, maintenance,
and protection of property; (3) place barcodes on accountable property
to identify it as government property; and (4) maintain proper user-
level accountability, including custody receipts, for issued property.
IHS personnel also did not implement proper physical security controls
to safeguard property.
As discussed in our recent report, we made 10 recommendations to IHS to
update its policy and enforce property management policies. The
Department of Health and Human Services (HHS) agreed with 9 of our 10
recommendations. HHS did not agree with our recommendation to establish
procedures to track all sensitive equipment such as blackberries and
cell phones even if they fall under the accountable dollar threshold
criteria. We disagree with HHS's assessment and reiterate support for
our recommendations.
IHS Has Had Millions of Dollars in Lost or Stolen Property:
We substantiated the allegation of gross mismanagement of property at
IHS. Specifically, we found that thousands of computers and other
property, worth millions of dollars, have been lost or stolen over the
past several years. We analyzed IHS reports for headquarters and the 12
regions from the last 4 fiscal years. These reports identified over
5,000 property items, worth about $15.8 million, that were lost or
stolen from IHS headquarters and field offices throughout the country.
The number and dollar value of this missing property is likely much
higher because IHS did not conduct full inventories of accountable
property[Footnote 8] for all of its locations and did not provide us
with all inventory documents as requested. Despite IHS attempts to
obstruct our investigation, our full physical inventory at headquarters
and our random sample of property at 7 field locations, identified
millions of dollars of missing property.
IHS Records Indicate at Least $15.8 Million of Property Is Lost or
Stolen:
Our analysis of Report of Survey[Footnote 9] records from IHS
headquarters and field offices show that from fiscal year 2004 through
fiscal year 2007, IHS property managers identified over 5,000 lost or
stolen property items worth about $15.8 million. Although we did
receive some documentation from IHS, the number and dollar value of
items that have been lost or stolen since 2004 is likely much higher
for the following reasons. First, IHS does not consistently document
lost or stolen property items. For example, 9 of the 12 IHS regional
offices did not perform a full physical inventory in fiscal year 2007.
Second, an average of 5 of the 12 regions did not provide us with all
of the reports used to document missing property for each year since
fiscal year 2004, as we requested. Third, we found about $11 million in
additional inventory shortages from our analysis of inventory reports
provided to us by IHS, but we did not include this amount in our
estimate of lost or stolen property because IHS has not made a final
determination on this missing property. Some of the egregious examples
of lost or stolen property include:
* In April 2007, a desktop computer containing a database of uranium
miners' names, social security numbers, and medical histories was
stolen from an IHS hospital in New Mexico. According to an HHS report,
IHS attempted to notify the 849 miners whose personal information was
compromised, but IHS did not issue a press release to inform the public
of the compromised data.
* From 1999 through 2005, IHS did not follow required procedures to
document the transfer of property from IHS to the Alaska Native Tribal
Health Consortium, resulting in a 5-year unsuccessful attempt by IHS to
reconcile the inventory. Our analysis of IHS documentation revealed
that about $6 million of this property--including all-terrain vehicles,
generators, van trailers, pickup trucks, tractors, and other heavy
equipment--was lost or stolen.
* In September 2006, IHS property staff in Tucson attempted to write
off over $275,000 worth of property, including Jaws of Life equipment
valued at $21,000. The acting area director in Tucson refused to
approve the write-off because of the egregious nature of the property
loss.
GAO Inventory Testing Reveals Lost or Stolen IT Equipment at IHS
Headquarters:
To substantiate the whistleblower's allegation of missing IT equipment,
we performed our own full inventory of IT equipment at IHS
headquarters. Our results were consistent with what the whistleblower
claimed. Specifically, of the 3,155 pieces of IT equipment recorded in
the records for IHS headquarters, we determined that about 1,140 items
(or about 36 percent) were lost, stolen, or unaccounted for. These
items, valued at around $2 million, included computers, computer
servers, video projectors, and digital cameras. According to IHS
records, 64 of the items we identified as missing during our physical
inventory were "new" in April 2007.
During our investigation of the whistleblower's complaint, IHS made a
concerted effort to obstruct our work. For example, the IHS Director
over property misrepresented to us that IHS was able to find about 800
of the missing items from the whistleblower's complaint. In addition,
an IHS property specialist attempted to provide documentation
confirming that 571 missing items were properly disposed of by IHS.
However, we found that the documentation he provided was not dated and
contained no signatures. Finally, IHS provided us fabricated receiving
reports after we questioned them that the original reports provided to
us were missing key information on them. Figure 1 shows the fabricated
receiving report for a shipment of new scanners delivered to IHS.
Figure 1: Example of Questionable Receiving Report:
This figure is a picture of an example of a questionable receiving
report.
[See PDF for image]
Source: GAO analysis of IHS data.
[End of figure]
As shown in figure 1, there is almost a 3-month gap between the date
the equipment was received in September and the date that the receiving
report was completed and signed in December--even though the document
should have been signed upon receipt. In fact, the new receiving report
IHS provided was signed on the same date we requested it, strongly
suggesting that IHS fabricated these documents in order to obstruct our
investigation.
GAO Testing Identifies Lost or Stolen IT Equipment at Seven IHS Field
Locations:
We selected a random sample of IT equipment inventory at seven IHS
field offices to determine whether the lack of accountability for
inventory was confined to headquarters or occurred elsewhere within the
agency.[Footnote 10] Similar to our finding at IHS headquarters, our
sample results also indicate that a substantial number of pieces of IT
equipment were lost, stolen, or unaccounted for. Specifically, we
estimate that for the 7 locations, about 1,200 equipment items or 17
percent, with a value of $2.6 million were lost, stolen or unaccounted
for.[Footnote 11] Furthermore, some of the missing equipment from the
seven field locations could have contained sensitive information. We
found that many of the missing laptops were assigned to IHS hospitals
and, therefore, could have contained patient information and social
security numbers and other personal information.
Wasteful Purchases Identified During Inventory Tests:
IHS has also exhibited ineffective management over the procurement of
IT equipment, which has led to wasteful spending of taxpayer funds.
Some examples of wasteful spending that we observed during our audit of
headquarters and field offices include:
* Approximately 10 pieces of IT equipment, on average, are issued for
every one employee at IHS headquarters. Although some of these may be
older items that were not properly disposed, we did find that many
employees, including administrative assistants, were assigned two
computer monitors, a printer and scanner, a blackberry, subwoofer
speakers, and multiple computer laptops in addition to their computer
desktop. Many of these employees said they rarely used all of this
equipment, and some could not even remember the passwords for some of
their multiple laptops.
* IHS purchased numerous computers for headquarters staff in excess of
expected need. For example, IHS purchased 134 new computer desktops and
monitors for $161,700 in the summer of 2007. As of February 2008, 25 of
these computers and monitors--valued at about $30,000--were in storage
at IHS headquarters. In addition, many of the computer desktops and
monitors purchased in the summer of 2007 for IHS headquarters were
assigned to vacant offices.
Weak Tone at the Top and Other Control Weaknesses Leave IHS Highly
Vulnerable to Loss, Theft, and Waste:
The lost or stolen property and waste we detected at IHS can be
attributed to the agency's weak internal control environment and its
ineffective implementation of numerous property policies. In
particular, IHS management has failed to establish a strong "tone at
the top" by allowing inadequate accountability over property to persist
for years and by neglecting to fully investigate cases related to lost
and stolen items. Furthermore, IHS management has not properly updated
its personal property management policies, which IHS has not revised
since 1992. Moreover, IHS did not (1) conduct annual inventories of
accountable property; (2) use receiving agents for acquired property at
each location and designate property custodial officers in writing to
be responsible for the proper use, maintenance, and protection of
property; (3) place barcodes on accountable property to identify it as
government property; (4) maintain proper individual user-level
accountability, including custody receipts, for issued property; (5)
safeguard IT equipment;[Footnote 12] or (6) record certain property in
its new property management information system.[Footnote 13]
Implementation of GAO Recommendations Will Lead to Better Management of
IHS Property:
To strengthen IHS's overall control environment and "tone at the top",
we made 10 recommendations to IHS to update its policy and enforce
property management policies of both the HHS and IHS. Specifically, we
recommended that the Director of IHS should direct IHS property
officials to take the following 10 actions:
* Update IHS personal property management policies to reflect any
policy changes that have occurred since the last update in 1992.
* Investigate circumstances surrounding missing or stolen property
instead of writing off losses without holding anyone accountable.
* Enforce policy to conduct annual inventories of accountable personal
property at headquarters and all field locations.
* Enforce policy to use receiving agents to document the receipt of
property and distribute the property to its intended user and to
designate property custodial officers in writing to be responsible for
the proper use, maintenance, and protection of property.
* Enforce policy to place bar codes on all accountable property.
* Enforce policy to document the issuance of property using hand
receipts and make sure that employees account for property at the time
of transfer, separation, change in duties, or on demand by the proper
authority.
* Maintain information on users of all accountable property, including
their buildings and room numbers, so that property can easily be
located.
* Physically secure and protect property to guard against loss and
theft of equipment.
* Enforce the use of the property management information system
database to create reliable inventory records.
* Establish procedures to track all sensitive equipment such as
blackberries and cell phones even if they fall under the accountable
dollar threshold criteria.
HHS agreed with 9 of the 10 recommendations. HHS disagreed with our
recommendation to establish procedures to track all sensitive equipment
such as blackberries and cell phones even if they fall under the
accountable dollar threshold criteria. We made this recommendation
because we identified examples of lost or stolen equipment that
contained sensitive data, such as a PDA containing medical data for
patients at a Tucson, Arizona area hospital. According to an IHS
official, the device contained no password or data encryption, meaning
that anyone who found (or stole) the PDA could have accessed the
sensitive medical data.[Footnote 14] While we recognize that IHS may
have taken steps to prevent the unauthorized release of sensitive data
and acknowledge that it is not required to track devices under a
certain threshold, we are concerned about the potential harm to the
public caused by the loss or theft of this type of equipment.
Therefore, we continue to believe that such equipment should be tracked
and that our recommendation remains valid.
Mr. Chairman and Members of the Committee, this concludes our
statement. We would be pleased to answer any questions that you or
other members of the committee may have at this time.
Contacts and Acknowledgments:
For further information about this testimony, please contact Gregory D.
Kutz at (202) 512-6722 or kutzg@gao.gov. Contact points for our Offices
of Congressional Relations and Public Affairs may be found on the last
page of this testimony. In addition to the individual named above, the
individuals who made major contributions to this testimony were
Verginie Amirkhanian, Erika Axelson, Joonho Choi, Jennifer Costello,
Jane Ervin, Jessica Gray, Richard Guthrie, John Kelly, Bret Kressin,
Richard Kusman, Barbara Lewis, Megan Maisel, Andrew McIntosh, Shawn
Mongin, Sandra Moore, James Murphy, Andy O'Connell, George Ogilvie,
Chevalier Strong, Quan Thai, Matt Valenta, and David Yoder.
[End of section]
Footnotes;
[1] GAO, IHS Mismanagement Led to Millions of Dollars in Lost or Stolen
Property, GAO-08-727 (Washington, D.C.: June 18, 2008).
[2] IHS headquarters property consists mostly of IT equipment.
[3] We considered equipment to be lost or stolen in our physical
inventory testing and random sample testing of seven field locations if
we could not observe the item to confirm bar code and serial number, or
if IHS could not provide us with adequate documentation to support the
disposal of the equipment.
[4] The seven sites we selected account for 35 percent of the IT
equipment items or 40 percent of the value of IT equipment. The seven
locations we tested included both IHS area offices and service units
such as hospitals and supply centers.
[5] A forensic audit is a systematic evaluation of the effectiveness of
internal controls over a program, process, and/or policies and
procedures. Forensic audits identify ineffective controls and
vulnerabilities and use data mining and investigations to expose areas
of fraud, waste, abuse, and security vulnerabilities to show the effect
of inadequate controls.
[6] The amount of lost or stolen property stated throughout the report
was valued at acquisition cost which is how IHS typically values the
property in its records.
[7] More specifically, each IHS employee is issued approximately 3
computers per person.
[8] Accountable personal property is personal property with an
acquisition value of $5,000 or greater and all sensitive items with a
value of $500 or greater.
[9] Report of Survey is the document used to record and present
findings and recommendations concerning the loss, theft, damage, or
destruction of government property, to approve corrective actions,
including financial recovery efforts, and to approve the resulting
adjustments to property accountability records.
[10] We selected the seven field locations based on book value of
inventory and geographic proximity. Five field office locations were
selected because they had the highest dollar amount of IT equipment. We
selected 2 additional sites because of their geographic proximity to
the other field offices being tested.
[11] Because these estimates are based on a probability sample, they
are subject to sampling error. For example, we are 95 percent confident
that missing IT equipment is valued between $1.39 million and $4.53
million. Likewise, we are 95 percent confident that between 12 and 22
percent (or between 893 and 1588) of the IT equipment items were lost
or stolen.
[12] For example, as noted in our recent report, because IHS did not
properly protect its equipment against damage or destruction, IHS had
to dispose over $700,000 worth of equipment because it was infested
with bat dung.
[13] Because IHS has not entered all property information into its new
property management information system, it does not have reliable
inventory records related to expensive, sensitive, and pilferable
property. Specifically, our investigation found that IHS failed to
enter over 18,000 items, worth approximately $48 million, from
headquarters and the sites we reviewed. Furthermore, over half of the
items we selected while performing our random sample testing of the
seven field locations were not recorded in the new property management
information system.
[14] This increased the risk that sensitive information could be
disclosed to unauthorized individuals and was in violation of federal
policy: OMB Memorandum M-07-16, Safeguarding Against and Responding to
the Breach of Personally Identifiable Information (May 22, 2007).
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