Indian Health Service Sanitation Facilities Construction Program

Indian Health Service Sanitation Facilities Construction Program is sponsored by Indian Health Service (IHS). This opportunity supports mission-aligned projects and measurable outcomes.

Indian Health Service's Controls Over Sanitation Facilities Construction Program Projects Funded Under the Infrastructure Investment and Jobs Act Could Be Improved Issued on 05/30/2025  | Posted on 06/03/2025  | Report number: A-05-22-00021 Full Report (PDF, 6. 0 MB) Report Highlights (PDF, 140. 9 KB) The Infrastructure Investment and Jobs Act (IIJA) appropriated $3.

5 billion to the Indian Health Service (IHS) for Sanitation Facilities Construction (SFC) Program projects to provide safe water, wastewater, and solid waste systems for American Indian and Alaska Native (AI/AN) people. The IIJA funding represents more than a fourfold increase in total annual SFC Program funding compared to previous years.

IHS uses the Sanitation Deficiency System (SDS) to document and prioritize sanitation deficiencies related to individual AI/AN people’s homes and communities and identifies existing deficiencies as projects. As such, it is important that the SDS contain accurate information.

We performed this audit to determine whether IHS has internal controls for identifying, recording, and tracking projects in the SDS and for ensuring that IIJA-appropriated funds are used only for eligible project costs. Although IHS had internal controls in place to track projects in the SDS, some weaknesses existed to identify and record projects in that system and to ensure that IIJA funds were only used for eligible project costs.

Specifically, IHS did not implement controls for identifying which projects to fund and did not properly record some projects in the SDS with the required documentation. In addition, we found that IHS did not effectively validate home eligibility or include all necessary information in the SDS to support the calculation of eligible costs.

Finally, although we found IHS did have guidance and processes in place to prorate eligible and ineligible Tier 1 construction costs, we found IHS did not have formal guidance or an established process to prorate the eligible and ineligible shares of Tier 1 design costs or Tier 2 and 3 planning costs.

We made five recommendations to IHS to improve controls for identifying and recording SFC Program projects funded under IIJA and for ensuring IIJA funds are used only for eligible project costs. The full recommendations are in the report. IHS concurred with three recommendations, partially concurred with one recommendation, and did not concur with one recommendation.

IHS detailed steps it has taken and plans to take in response to our recommendations. Recommendation Details (5) 25-A-05-067. 01 to IHS - Closed Acceptable Alternative We recommend that the Indian Health Service consider additional project prioritization procedures to fund the highest priority SFC projects based on readiness.

25-A-05-067. 02 to IHS - Closed Implemented We recommend that the Indian Health Service reinforce compliance with established procedures for recording and documenting projects in the SDS prior to funding them. 25-A-05-067.

03 to IHS - Closed Implemented We recommend that the Indian Health Service validate the eligibility of homes and users by regularly reviewing and updating the HITS data. 25-A-05-067. 04 to IHS - Closed Implemented We recommend that the Indian Health Service strengthen documentation controls to appropriately ensure that all information is entered in the SDS to identify the ineligible portion of Tier 1 construction projects.

25-A-05-067. 05 to IHS - Open Unimplemented We recommend that Indian Health Service develop formal guidance for the proration of Tier 1 design costs and Tier 2 and 3 planning costs between eligible and ineligible homes or users. View in Recommendation Tracker Departmental Operational Issues This report may be subject to section 5274 of the National Defense Authorization Act Fiscal Year 2023, 117 Pub.

L. 263 .