Indiana Did Not Fully Comply With Federal Waiver and State Health, Safety, and Administrative Requirements at 30 Residential Settings

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 Indiana provided oversight of Home and Community-Based Services (HCBS) residential providers serving Medicaid enrollees with developmental disabilities to ensure they complied with Federal and State health and safety requirements.

What OIG Found

• Indiana did not fully comply with Federal waiver and State requirements in overseeing residential providers that serve individuals with developmental disabilities who received supported living services through the HCBS program.
• Of the 20 residential providers and 30 residential settings we reviewed, we found 246 instances of provider noncompliance with administrative, health, safety, and residential records requirements. Specifically, we identified:
  • 15 residential providers that did not comply with 1 or more administrative requirements, resulting in 46 instances of provider noncompliance, and
  • 29 residential settings that were not in compliance with 1 or more health, safety, and residential records requirements, resulting in 200 instances of provider noncompliance.

What OIG Recommends

We made three recommendations to Indiana, including that it work with residential providers to correct the 246 instances of provider noncompliance we identified; improve its oversight and monitoring of residential providers; and work with the residential providers to improve internal controls for health and safety, maintenance of records, and training.

Indiana did not indicate concurrence or nonconcurrence with our recommendations. However, it detailed steps it has taken or plans to take in response to our recommendations.

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