Audit Audit of the Department of Developmental Services (DDS)

Audit provided recommendations to improve the safety and care for individuals with disabilities throughout the Commonwealth. The audit examined the period July 1, 2017 through June 30, 2019.

Organization:	Office of the State Auditor
Date published:	June 29, 2021

Executive Summary

In accordance with Section 12 of Chapter 11 of the Massachusetts General Laws, the Office of the State Auditor has conducted a performance audit of the Department of Developmental Services (DDS) for the period July 1, 2017 through June 30, 2019. In this performance audit, we examined processes to review allegations of suspected abuse, mistreatment, and other incidents that would pose a risk of serious harm to DDS clients, as well as the processing of incident reports and medication occurrence reports (MORs) in provider-operated group homes. Our purpose was to determine whether DDS completed these processes on time and in accordance with its policies and procedures.

Below is a summary of our findings and recommendations, with links to each page listed.

Finding 1	DDS did not always issue decision letters for its investigations within required timeframes.
Recommendations	DDS should work with the Disabled Persons Protection Commission (DPPC) to complete investigations and issue decision letters within 45 business days. DDS should formalize the necessary policies and procedures to require that regional senior investigators monitor investigations for timeliness and ensure that any necessary extensions are properly requested, documented, and approved. If DDS believes that inadequate staffing is contributing to this issue, it should determine the staffing level it would need to meet the required timeframes and seek funding to reach that level.
Finding 2	DDS did not consistently meet its deadlines for developing action plans for alleged victims of abuse or mistreatment.
Recommendation	DDS should enhance its policies and procedures by implementing effective monitoring controls to ensure that action plans are developed within required timeframes.
Finding 3	DDS did not properly manage all administrative reviews.
Recommendation	DDS should implement policies, procedures, and monitoring controls to ensure that administrative reviews are completed by the regional director or his/her designees.
Finding 4	DDS did not ensure that its provider-operated group homes submitted and finalized incident reports within the prescribed timeframes.
Recommendation	DDS should work with provider-operated group homes and establish effective monitoring controls to ensure that all incident reports are submitted and finalized on time.
Finding 5	DDS did not ensure that MORs were created, finalized, and reviewed within the prescribed timeframes.
Recommendations	DDS should implement effective monitoring controls in its policies and procedures to ensure that provider-operated group homes create and finalize MORs, and Medication Administration Program coordinators review them, within the prescribed timeframes. If DDS believes that inadequate staffing is contributing to this issue, it should determine the staffing level it would need to meet the required timeframes and seek funding to reach that level.
Finding 6	DDS did not ensure that its employees always received security awareness training.
Recommendations	DDS should offer security awareness training each year. DDS should develop a formal process to ensure that security awareness training is completed on time.

A PDF copy of the audit of the Department of Developmental Services is available here.

Post-Audit Action

On June 14, 2021, DDS gave us the following update on the actions taken to address our audit findings since the end of our audit fieldwork.

DDS has formalized its practice of monitoring the timeliness of all investigation reports and decision letters through bi-weekly supervisory meetings of its senior investigators and investigators, and has directed that in all cases where decision letters are awaiting approval by DPPC or are referred to law enforcement and are therefore pending, the senior investigator or investigator must submit an extension request pursuant to [Section 9.10(5) of Title 115 of the Code of Massachusetts Regulations].

DDS has formed a workgroup consisting of staff from the DDS Bureau of Program Integrity, senior managers, and operations staff to develop and implement systems for the monitoring of timeframes for completion of action plans and administrative reviews across the state. Draft protocols for the completion of action plans and administrative reviews have been developed and are under review for input of stakeholders including Regional and Area Office staff responsible to ensure their timely completion.

The DDS Office of Quality Enhancement (OQE) issued an Advisory (June 4, 2021) to all providers on the importance of timely submission of incident reports. OQE has formed a workgroup consisting of staff from the Bureau of Program Integrity and DDS Operations to employ data analytics strategies to ensure the timely submission of incident reports by DDS providers.

Downloads

Open PDF file, 1010.53 KB, Audit of the Department of Developmental Services (English, PDF 1010.53 KB)

Contact

Phone

Main (617) 727-2075

Online

Auditor@MassAuditor.gov

Fax

(617) 727-3014

Address

Massachusetts State House
Room 230
Boston, MA 02133

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