Connecticut Could Better Ensure That the Department of Developmental Services and Providers Fully Comply With Federal Waiver and State Health and Safety Requirements for Individualized Home Support Services

Why OIG Did This Audit

• OIG conducts health and safety audits of supported living services, adult day care, foster care homes, and regulated child care facilities.
• Previous audits identified multiple health and safety issues that put children and people with special health care needs at risk.
• This audit examined whether the Connecticut Department of Social Services (State agency) ensured the Connecticut Department of Developmental Services (DDS) and providers complied with Federal and State health and safety requirements to ensure the health and safety of Medicaid enrollees with intellectual and developmental disabilities receiving individualized home support services.

What OIG Found

Connecticut did not ensure that the provider certification process was followed properly (32 instances for the 81 providers we reviewed), individual plans were reviewed at least annually (6 instances in the 124 individual plans we reviewed), and critical incidents were properly reported and recorded (70 instances).

For the 5 site visits we performed, providers did not complete, as required, criminal background checks (23 instances) and abuse and neglect registry checks (29 instances). In addition, they did not ensure that mandatory training was completed within required timeframes (106 instances).

What OIG Recommends

We made four recommendations, including that the State agency work with DDS to: (1) develop and implement written policies and procedures for the provider certification process; (2) ensure that individual plans are reviewed timely; (3) fully implement its critical incident reporting and monitoring system and take appropriate follow-up action; and (4) ensure providers improve internal controls for criminal background checks, abuse and neglect registry checks, maintenance of records, and training. The full recommendations are in the report.

The State agency concurred with all four recommendations.

---