Louisiana Faced Compliance and Contracting Challenges in Implementing Opioid Response Grant Programs

Why OIG Did This Audit

The HHS, Substance Abuse and Mental Health Services Administration, awarded a series of grants to States and Tribes to combat opioid use disorder. These grants included the Opioid State Targeted Response (STR) and the State Opioid Response (SOR) grants. The purposes of these grants were to increase access to treatment, reduce unmet treatment needs, and reduce opioid overdose-related deaths.

Our objective was to determine how Louisiana implemented programs under the Opioid STR and SOR grants and whether the activities of Louisiana entities responsible for implementing the programs complied with Federal regulations and met grant program goals.

How OIG Did This Audit

Our audit period covered May 1, 2017, through October 31, 2019, for the STR grant and September 30, 2018, through September 29, 2019, the first year of the SOR grant. To accomplish our audit objective, we reviewed STR and SOR grant documentation and interviewed Louisiana officials to determine how programs were implemented and whether Louisiana complied with Federal regulations and met grant program goal requirements during the audit.

What OIG Found

Louisiana implemented STR grant programs by expanding prevention, treatment, and recovery services for opioid use disorder. However, we found that Louisiana faced challenges in complying with Federal regulations related to reporting and oversight. Additionally, Louisiana met program goals of the STR grant for prevention, treatment, and recovery services, but did not adequately address challenges it faced meeting grant terms.

During the first year of the SOR grant, Louisiana implemented a collaborative approach to enhance and expand the capacity of treatment providers. Louisiana created crisis mobile teams to increase outreach to community programs by partnering with the Local Governing Entities (LGEs) and expanded access to recovery support services by increasing safe recovery housing. Louisiana complied with Federal regulations related to the SOR grant. However, we found that it did not meet treatment services and naloxone distribution goals during the first year of its SOR grant.

What OIG Recommends and Louisiana's Comments

We recommend that Louisiana (1) develop a process to ensure accurate reporting on the Annual Progress Reports, (2) improve monitoring of subrecipients to ensure that distribution of naloxone kits are tracked and distribution requirements are met, (3) work with the LGEs and Opioid Treatment Programs to identify ways to support clients' access to transportation to obtain treatment and determine how transportation could be addressed in each specific region of the State, and (4) review the contracting process to determine whether there are ways to expedite the process to provide funds to subrecipients and outside organizations in a timely manner.

In written comments on our draft report, Louisiana concurred with most of our findings and all of our recommendations. Louisiana stated that it had hired a data analyst to monitor the integrity of data for consistent and accurate reporting. Louisiana also stated that it had developed a workgroup to help expedite the contract review process and is hiring additional staff to review contracts for accuracy. OBH disagreed with our findings that it had no assurance naloxone kits were distributed to target populations and that it did not adequately address transportation challenges. We maintain that our findings are valid and provide further information in the report.