Overview
During our audit period, 3 (5%) of the 60 administrative reviews in our sample were referred to an area office but were never conducted, and 6 others (10% of the total) were not conducted properly; they were completed by CRTs rather than by DDS regional directors or their designees as required by regulation. When administrative reviews are not completed or are conducted improperly, DDS cannot ensure prompt implementation of actions outlined in resolution letters to address potential harm.
Authoritative Guidance
According to 115 CMR 9.11, “An administrative review shall be conducted by the regional director or designee for all complaints referred pursuant to 115 CMR 9.05(2).”
Reasons for Issue
DDS had not implemented policies, procedures, and monitoring controls to ensure that the required administrative reviews were completed on time by the appropriate personnel.
Recommendation
DDS should implement policies, procedures, and monitoring controls to ensure that administrative reviews are completed by the regional director or his/her designees.
Auditee’s Response
DDS agrees that administrative reviews were not always completed by the regional director or his or her designee and were inconsistent in how the administrative review process was implemented across the state. The OSA found some administrative reviews were completed by staff other than the regional director or their designee, such as a program monitor, or the CRT, and through delegation to Provider staff. . . .
DDS agrees that it should develop internal monitoring controls to ensure that administrative reviews are consistently completed by the regional director or his or her designee. DDS has formed a workgroup consisting of staff from the Bureau of Program Integrity, senior managers, and operations staff to develop and communicate consistent policies around the completion of administrative reviews.
Auditor’s Reply
Based on its response, DDS is taking measures to address our concerns in this area.
| Date published: | June 29, 2021 |
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