Performance Audits in Progress

Washington’s Agricultural Commodity Commissions: An assessment of effectiveness (winter 2022-23)

Washington’s 21 agricultural commodity commissions primarily engage in activities related to marketing, research and education. The state considers each an independent state agency. Commissions collect around $45 million annually in compulsory assessment fees levied on producers to fund their programs. This audit seeks to understand the benefits that these commissions provide to Washington’s producers and its agricultural industry. Our assessments will be based on the commissions’ activities and the perspectives of the producers. The audit will also identify any potential opportunities to enhance those benefits. The audit will include a survey of the state’s producers, designed by our Office and Washington State University in cooperation with the commissions’ staff, to capture producer’s perspectives about the commissions’ current activities and the best way for commissions to address challenges their industries face in the future. Read the one-page summary (PDF).

Growth Management Act: City and county compliance with the Act’s 120-day permitting requirement (tentative)

The state’s Growth Management Act requires cities and counties to issue construction and land development permits no later than 120 days after receiving the developer’s application, providing the application is complete and meets all state and municipal requirements. Legislators have expressed concerns that some cities and counties are not complying with this requirement. Some may have also insisted that developers sign waivers that exempt the issuers from the 120-day requirement. There could be economic consequences if jurisdictions are not complying with the Act. For example, it could mean less predictability for construction and land development applicants and possibly increases in housing costs. This audit would examine the extent to which a selection of cities and counties are complying with this 120-day rule.

Evaluating Customer Service at Washington’s Department of Employment Security (late fall 2022)

Washington’s Employment Security Department (ESD) administers the state’s unemployment compensation program. The flood of claims unemployment claims associated with the COVID-19 pandemic strained ESD’s infrastructure and staff. This caused long delays in benefits payments and overwhelmed ESD’s call center capacity. In early 2021, our Office released a performance audit of ESD’s pandemic response that identified factors that led to those problems. The most notable finding concerned the lack of sufficient numbers of trained staff. This follow-up audit will examine ESD’s implementation of a new state law (ESSB 5193) that required the agency to make specific improvements to customer service. Read the one-page summary (PDF).

Contracted Homelessness Services: Improving how local governments prioritize contracts and manage provider performance (fall 2022)

Washington has a growing population of people without homes, especially in its highly populated urban areas. Many local governments have devoted significant resources to addressing the homelessness problem, including contracting for services through not-for-profit agencies. Stakeholders have raised concerns about some of those contracts, noting that contracts lacked required performance targets and demonstrated results. This audit will examine the processes selected cities and counties used to identify and prioritize the homeless services they procure. It will also look at how they monitor and manage provider performance. The audit seeks to identify recommendations that would help local governments contract for more effective services. Read the one-page summary (PDF).

Evaluating the Prescription Monitoring Program (fall 2022)

When Washington’s pharmacists fill prescriptions for controlled substances, they upload this information to the state’s Prescription Monitoring Program (PMP) database. Doctors check the database when they prescribe opioids to make sure patients do not receive an unsafe quantity or combination of medications. This audit will examine PMP data to identify any unusual prescribing and dispensing patterns that suggest instances of doctor or pharmacy shopping or overprescribing. Because the Department of Health (DOH) does not analyze PMP data for these purposes, this audit could identify a need for DOH to do so. In addition, it could identify providers who have prescribed opioids, but have not registered or queried the PMP database as required. This audit will also examine how to improve the quality and timeliness of data in the PMP system. Read the one-page summary (PDF).

I-1163: Testing and Certification Barriers for Home Care Aides (late summer 2022)

Initiative 1163 requires many long-term care workers become certified to provide in-home care to elderly and disabled people. To become certified, caregivers complete 75 hours of training, submit an application for certification, and successfully pass both knowledge and skills tests. The Department of Health (DOH) oversees certification of long-term care workers. DOH contracts with a private testing company to organize and administer the test at sites available across the state. However, long-term care workers have described many challenges with the testing process. These include: • Problems scheduling the test, which takes place at a different time and location than their training; • Requirements to take the test in person because they cannot take the skills portion remotely; • Getting to the test site (in some parts of the state). This legislatively mandated audit examines DOH’s process to test and certify home care aides to find out where applicants encounter barriers and experience delays. Read the one-page summary (PDF).

Improving Administrative Processes and the Nursing and Medical Commissions (winter 2023)

The Nursing Care Quality Assurance Commission and Washington Medical Commission work in tandem with the Department of Health (DOH) to ensure physicians and nurses are providing quality healthcare. DOH establishes administrative procedures, licensing requirements and fees. However, discipline and standards of practice (including establishing, monitoring and enforcing qualifications for licensure) lie fully with the commissions. Stakeholders are concerned about a systemic licensure backlog problem at both the nursing and medical commissions. These backlogs persist despite DOH staff stepping in to help commission employees process delayed paperwork. A contracted audit firm will conduct these two audits, which will address additional concerns specific to each commission. Read the two-page summary of both projects (PDF).

Improving Services to Help Prevent Placement in Unfamiliar Foster Homes (suspended indefinitely)

The Department of Children, Youth & Families (DCYF) oversees the state’s foster care system. That system is overburdened and does not have enough suitable homes for the number of children in the system. This audit will examine how effectively DCYF supports children who are at risk of entering the foster care system by providing services that allow them to remain in familiar settings rather than enter the foster care system. Specifically, it will look for opportunities to improve family preservation services that help children remain in their homes, and kinship care services that help place children with a family member or family friend. Read the one-page summary (PDF).  

Department of Health: Effectiveness and equity in Washington’s COVID-19 vaccine rollout (tentative)

The COVID-19 pandemic required a large and coordinated response between many governmental agencies and private organizations. Washington’s Department of Health (DOH) worked with the federal government, other state agencies and many partners to provide vaccines to residents. These partners included local health departments, non-profit organizations, healthcare facilities and pharmacists. Some demographic groups continue to have lower vaccination rates than others. Even after states have fully responded to this pandemic, experts warn that future pandemics will likely occur. This audit would evaluate the effectiveness of DOH’s rollout of the COVID-19 vaccine. It will also identify opportunities to improve the effectiveness and equity of future public health event responses. 

Medicaid Managed Care: Ensuring rates paid to MCOs reflect accurate data and program integrity efforts (tentative) 

Washington’s Health Care Authority (HCA) contracts with managed care organizations (MCOs) to provide Medicaid services to eligible Washingtonians. Almost one-fourth of the state’s population – 1.7 million people – receive medical and behavioral healthcare through one of five contracted MCOs. During fiscal year (FY) 2020, these five MCOs received more than one-quarter of the state’s non-restricted budget ($7.5 billion). One MCO received about $3.6 billion. The cost of Medicaid increases every year: the state spent 5 percent more in FY 2020 compared to 2019. Because people who qualify for Medicaid are eligible to receive services under the program, HCA does not control costs by capping the number of people who can enroll in the program. However, HCA can control costs by tightening program integrity efforts and verifying the accuracy of encounter data supplied by MCOs. This audit would determine if the monthly premium rates HCA pays to MCOs are based on accurate encounter data and reflect MCO program integrity efforts, such as identified overpayments. Recommendations from this audit could lead to significant cost savings for the state.

No topics currently in the 2021-23 workplan.

Information Technology: Reducing risk through better IT legacy system management (tentative)

Nearly one-third of IT systems at Washington executive branch agencies are legacy systems that do not meeting evolving business needs. A legacy system is a computer system based on outdated technology; it is usually incompatible with current solutions, and challenging to maintain and update. Past SAO audits have shown that reviewed state agencies did not account for the full costs of operating and maintaining their legacy systems, nor did they perform proper risk or cost-benefit analyses on whether and how to improve upon legacy systems. This audit will examine how effectively selected agencies identify, track and monitor the use and maintenance of legacy systems. It will also examine their efforts to prioritize and execute updating, replacing or retiring such systems. The audit will look for practices that could help agencies fundamentally enhance information security and manage their IT resources.

K-12 Education: Lessons learned from the COVID-19 pandemic (tentative)

This broadly scoped audit will explore lessons learned from providing a free and appropriate public education during a global pandemic. The break from the physical classroom may bring to light hidden reasons why some students struggle while others succeed. The scoping phase for this project will begin by identifying the key lessons learned during the pandemic regarding public education. Auditors will then select one or more topics to pursue, potentially through a series of audits. The audit will likely make recommendations in two areas. First, to improve education in Washington going forward, and second to better position the state should future events call for long-term school closures. 

Sexual Assault Kits: Assessing Washington State Patrol’s tracking system and testing backlog (late fall 2022)

The DNA evidence obtained after a sexual assault occurs has the power to identify the assailant, The DNA evidence obtained after a sexual assault occurs has the power to identify the assailant, exonerate the innocent, and link cases together. This evidence is typically collected from the survivor at a medical facility, and preserved in a sexual assault kit. Law enforcement officials must process the kit in a timely manner to resolve the crime and ensure justice is served. However, in 2018, the Washington State Patrol (the Patrol), the Attorney General’s Office, and local law enforcement agencies determined that more than 9,000 kits had not been submitted for testing at the time. Changes in state law imposed requirements on the Patrol and local agencies to speed up testing and clear the backlog. It also put a new tracking system in place to provide more transparency around the processes. This legislatively mandated audit examines the statewide sexual assault kit tracking system. It also reviews how the State Patrol Crime Laboratory processes sexual assault kits. Read the one-page summary (PDF).

Civil Asset Forfeiture in Washington (tentative)

This audit would examine the use of civil asset forfeiture by the state’s law enforcement agencies. Civil asset forfeiture allows law enforcement agencies to seize – and then keep or sell – any property alleged to have been involved in a crime. Under state law, law enforcement may seize property even if the property owners have not been arrested or convicted. The intention of civil asset forfeiture is to deter criminal activity and disrupt criminal organizations. The audit could examine whether forfeiture functions as originally intended. Possible areas of interest include analyzing the types of offenses that lead to asset forfeiture, and the effect on property owners and crime rates. Another area of interest considers how the state uses seized funds. The audit could also review asset forfeiture data reported by law enforcement agencies to the state treasurer.

WSDOT Toll Collection System Replacement Project (late fall 2022)

A 2013 performance audit examining the Washington State Department of Transportation (WSDOT) tolling system project made a number of recommendations to reduce project risk, improve project management, and improve vendor accountability. In 2016, a second performance audit found WSDOT had accumulated $96.4 million in outstanding tolls, fees and penalties. Of this amount, WSDOT estimated it could recover only $37.1 million. This was due in part to limitations in the toll collection system. To address these problems, WSDOT obtained funding from the Legislature in 2016 to develop a new $27.9 million toll collection system. The new project gave WSDOT the opportunity to apply audit recommendations to gain efficiencies in various tolling business processes. It could also incorporate lessons learned from the first back-office system. The audit recommended WSDOT address customer account management, customer service operations, mobile-friendly customer tools, and accounting and financial management. This legislatively mandated audit will evaluate whether WSDOT has implemented lessons learned from the previous tolling project’s delays. It will also consider whether WSDOT provided adequate oversight of the current project. Read the one-page summary of this audit (PDF).