(The Center Square) — The Louisiana Department of Health improved its response time for allegations of abuse and neglect in home and community based services for individuals with developmental disabilities.
The department’s improvement is according to an audit of their internal controls from the Louisiana Legislative Auditors for fiscal years 2019 through 2023.
The audit says the department conducted 1,979 surveys that addressed 5,420 separate allegations of noncompliance, with 2,194 related to abuse or neglect. Of 848 complaint survey’s during 2022 and 2023, 843, or 99.4%, were completed in accordance with required timelines.
That is a significant improvement from the three previous years according to the audit. The department substantiated 650 of the abuse or neglect allegations in the home and community based services.
When the department substantiates an allegation, it is of noncompliance with regulations, and not necessarily an indication of abuse or neglect by law. Other agencies are responsible for that.
However, not complying with regulation could mean a provider fails to ensure a client remained safe from abuse or a provider failed to follow written policy or procedures related to neglect.
An audit of intermediate care facilities, which The Center Square reported on back in July, found similar improvements in timeliness of surveys.
Care facilities are more permanent, supervised versions whereas home and community based services provide more independence and bring services to the individuals with disabilities.
Like with that audit, this one showed not everything was positive.
The reason there were so many instances of abuse and neglect to begin with could be because the department failed to conduct 140 licensure surveys in a timely manner of the total 546 providers. In addition, 69 providers had no licensure surveys at all during this five-year period.
These surveys ensure the license’s for these services are up to regulation standards, meaning some services might not of been allowed to operate had these survey’s been done.
Auditors said the department faced numerous challenges in confirming that critical incident reports were submitted timely and in accordance with program requirements.
The department also did not ensure that eight of 36 support coordination providers received all required annual monitoring reviews. Auditors stated the department has not established a process to confirm that proper and timely corrective actions are taken by support coordination agencies.
All this means that although the department checked in on allegations of abuse and neglect quickly and efficiently, they didn’t always take the proper steps to prevent the allegations from happening, ensure reports on the allegations were submitted properly, or provide sufficient corrective actions to punish based on the findings.
Auditors said two key challenges the department is facing are turnover of knowledgeable service workers and the number of entities involved in the process.
While there are too many agencies, there are too little workers.
Auditors suggest to not only address these issues and maintain proper reporting systems, but to raise fines for agencies with deficiencies, which have not grown since 1997.
