Texas Did Not Fully Comply With Federal Waiver and State Health, Safety, and Administrative Requirements at All 20 Adult Day Activity Health and Service Facilities Audited

Why OIG Did This Audit

• The OIG has conducted health and safety audits of adult day care and foster care homes and regulated childcare facilities.
• Previous audits identified multiple health and safety issues that put children and people with special health care needs at risk.
• This audit examines whether the Texas Health and Human Services Commission (Texas) complied with Federal waiver and State requirements in overseeing Day Activity and Health Services (DAHS) facilities that serve people with special health care needs who receive services through the program.

What OIG Found

• Texas did not fully comply with Federal waiver and State requirements in overseeing providers that serve people with special health care needs receiving DAHS services through the program.
• Of the 20 providers that we audited, 19 did not comply with 1 or more health and safety requirements, and 19 did not comply with 1 or more administrative requirements.
• In total, we found 253 instances of provider noncompliance with health, safety, and administrative requirements at the 20 providers that we audited.

What OIG Recommends

We recommend that Texas:

1. ensure that providers correct the 253 instances of provider noncompliance identified in this report;
2. improve its oversight and monitoring of providers; and
3. work with providers to improve their facilities, staffing, and training.

Texas concurred with all our recommendations and detailed steps it has taken and plans to take in response to our recommendations.