Objective

To determine the extent of implementation of the three recommendations included in our initial audit report, Addiction Support Services During Emergencies (2021-S-35).

About the Program

The Office of Addiction Services and Supports (OASAS) certifies providers to operate over 1,700 substance use disorder and problem gambling treatment and prevention programs (Programs) across the State, serving an average of 730,000 individuals per year. Programs are certified for a specified period that can be between 6 months and 3 years, at which time recertification is required. OASAS conducts unannounced recertification reviews to assess providers’ compliance with regulatory requirements using review instruments, which are lists of questions and areas to address, specific to each Program type (e.g., residential, inpatient, opioid treatment).

In 2019, OASAS issued guidance—referred to as Local Service Bulletins—to providers requiring them to maintain waiting lists for clients awaiting treatment. Additionally, certain providers, including residential treatment and inpatient rehabilitation providers, are required to develop, maintain, and update an Emergency Preparedness Plan (Plan) to help them prepare for, respond to, and/or recover from an internal or external emergency that may present an immediate danger to personnel, patients, Programs, and/or property. Providers must review their Plan annually and re-evaluate it following any incidents.

Further, in 2013, the State created the New York State Evacuation of Facilities in Disasters System (eFINDS), an application managed by the Department of Health that uses barcoded wristbands to track in real time the location of individuals being cared for in facilities and on-duty staff when relocation occurs during an emergency. In the event of an emergency, all OASAS-certified providers should use eFINDS to monitor where a patient gets evacuated from and relocated to.

The objective of our initial audit, issued in November 2023, was to determine if OASAS offered adequate guidance to providers to help ensure they’re able to deliver addiction support services during emergency situations. The audit found OASAS should improve the extent and clarity of its guidance to include strategies to manage and mitigate prolonged service disruptions and continue to deliver addiction support services. Additionally, OASAS needs to improve its monitoring of providers’ Plans. Specifically, OASAS personnel reviewed Plans only at initial certification despite guidance indicating they will review them during later site visits. Further, OASAS needs to do more to ensure that providers have access to and use eFINDS and improve the accuracy and usefulness of its waiting lists. The weaknesses identified indicate that Programs may not be adequately prepared for emergency situations, which could compromise safety and continuity of care of patients.

Key Findings

OASAS has made little progress in addressing the problems identified in our initial audit report and further improvements are needed. There have been some revisions to certain guidance; however, OASAS has not implemented procedures to ensure providers’ Plans address prolonged disruptions of service and that providers have appropriate access to eFINDS, or to improve the information in providers’ waiting lists. OASAS officials claim that all recommendations have been appropriately implemented and strongly disagree with our observations; however, they will continue to review areas identified in this report to identify whether additional advisements to providers are warranted. Of the initial report’s three recommendations, none have been implemented.

Key Recommendation

Officials are requested, but not required, to provide information about any actions planned to address the unresolved issues discussed in this follow-up within 30 days of the report’s issuance.