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DiNapoli: As Drug Overdoses Climbed the State Failed to Inspect Residential Drug Treatment Programs

Programs Operated With Little or No Oversight

December 3, 2021

New Yorkers in residential drug treatment programs have been poorly served by the failure of the state’s Office of Addiction Services and Supports (OASAS) to inspect and certify that the programs are safe and give proper treatment, both before and during the COVID pandemic, according to an audit released today by State Comptroller Thomas P. DiNapoli.

“The COVID pandemic wreaked havoc in the lives of many New Yorkers, including those vulnerable to addiction,” said DiNapoli. “Skyrocketing substance abuse over the past 18 months has created an overwhelming need for addiction treatment and recovery services. The Office of Addiction Services and Supports was inadequately inspecting and certifying residential treatment programs even before that, but when the state hit pause on inspections at residential treatment facilities during the pandemic, it put patients’ safety, security and treatment at even greater risk. We can never abandon vulnerable New Yorkers. I expect the agency to take swift steps to ensure these facilities are up to standards and providing the best care possible to all New Yorkers in need of their help.”

In a letter to the federal Department of Health and Human Services regarding its plan to use grant funding, OASAS noted that the 4,415 drug overdose deaths in New York from September 2019 to August 2020 reversed two years of declines. These deaths were 24% higher than during the same 12-month period the previous year and were the most in any September-August period on record. OASAS is on the front line in addressing this crisis and responsible for providing, certifying and inspecting vital addiction services for more than 680,000 New Yorkers each year. Residential programs, which serve some 8,000 New Yorkers annually, can be certified for 6-month, 1-, 2- or 3-year periods and are subject to recertification following an inspection. Due to the state’s declared COVID-19 disaster emergency, the agency suspended all on-site recertification reviews. These reviews are unannounced inspections of safety conditions, patient records, staffing and ability to meet reporting requirements.

DiNapoli’s audit found that even before the pandemic struck New York, certification for many residential treatment programs had lapsed with no inspections from OASAS. Without certification, it remained unknown if they were still providing adequate care for residents or had fixed problems found in earlier visits.

The audit, which included reviews of data from April 2017 to February 2021, found that all 76 residential programs due for recertification during the audit period were overdue. Of these, 49 were more than a year past due before the pandemic. They remained uninspected for at least 15 months more during the emergency period.

As a result, 28 programs were one to two years overdue for recertification, another 16 were two to three years overdue, five were more than three years overdue, and two programs never got a recertification review.

The audit also looked at 25 programs that had a combined total of 243 regulatory deficiencies identified in past OASAS reviews and found that 10 did not get any type of documented on-site visit during the recertification period. Auditors found inadequate documentation of specific actions planned or taken to fix 98 (40%) of these problems.

DiNapoli recommended OASAS takes steps to improve services for New Yorkers in treatment facilities by:

  • Doing recertification reviews for all overdue programs
  • Monitoring reviews to ensure they are done on time
  • Ensuring staff follow up with programs on correcting problems found during reviews.

In its response, OASAS officials agreed with all three recommendations and indicated actions they would take to implement them.

Audit
Audit of the Office of Addiction Services and Supports, Oversight of Chemical Dependence Residential Services


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