Objective

To determine the extent of implementation of the three recommendations included in our initial audit report, Oversight of Chemical Dependence Residential Services (2020-S-49).

About the Program

The Office of Addiction Services and Supports (OASAS) oversees one of the largest substance use disorder systems of care in the nation, with approximately 1,700 prevention, treatment, and recovery programs providing services for over 680,000 New Yorkers each year, including inpatient and residential services for about 8,000 individuals. OASAS’ regulations govern Chemical Dependence Residential Services (Part 819) delivered by certified providers. Part 819 can include three levels of residential services programs: community residential, supportive living, and intensive residential rehabilitation (our initial audit did not include a review of intensive residential programs). Part 820, adopted in 2015 as part of a redesign that added residential programs, includes three elements that the programs would be approved to provide either separately or in combination: stabilization, rehabilitation, and/or reintegration. The redesign was implemented with the expectation that Part 819 providers would convert their programs to Part 820. OASAS certifies residential services and issues operating certificates to providers that run Part 819 and Part 820 programs. Before issuing an operating certificate, OASAS is required to inspect programs for compliance with all applicable laws, rules, and regulations. In the case of recertification, OASAS must perform an inspection (or recertification review) and a fiscal viability review before the program’s current operating certificate expires.

The objective of our initial audit, issued in December 2021, was to determine whether OASAS properly monitored residential services to ensure conditions were safe and secure for patients. Specifically, the audit found OASAS did not adequately monitor the programs, as prescribed in the regulations and did not meet the recertification review requirements, as many residential programs continued to operate without OASAS completing recertification reviews before their due date. In addition, OASAS did not always conduct appropriate follow-up of programs to verify that all deficiencies had been addressed, including obtaining documentation from programs supporting that corrective actions had been taken.

Key Findings

OASAS officials have made progress in addressing the issues identified in our initial report. Of the initial report’s three recommendations, two were implemented and one was no longer applicable.