First, with respect to opioid use in the IHS, the OIG indicated its intent to determine the "extent to which beneficiaries are receiving extreme amounts of opioids through IHS, as well as IHS-employed prescribers and IHS-run pharmacies that have questionable prescribing or dispensing patterns." The OIG further noted that its review will evaluate how IHS "prevents and detects opioid misuse or abuse" and "enforces its opioid-related policies." The OIG's review is consistent with the agency's increasing focus on opioid abuse and overdose deaths.

Second, relating to the Head Start review, the OIG noted that it will be auditing a community-based, not-for-profit Head Start grantee to determine whether all Head Start costs claimed by the grantee were permissible under federal law and the terms of the grant. The Administration for Children and Families requested that the OIG perform this audit due to the grantee's "high risk of noncompliance with federal requirements."