Performance Audits in Progress

Evaluating Aquatic Land Lease Rates (early spring 2024)

The Department of Natural Resources (DNR) manages 2.6 million acres of state-owned aquatic lands. “Aquatic lands” refers to all tidelands, shorelands, harbor areas, and the beds of navigable waters. DNR leases some of this land to businesses or the public for purposes such as marinas, docks, aquaculture and more. Laws related to determining aquatic land lease rates have not been updated in many years, and there are concerns that unfair rates for certain industries or the state may exist. This audit will examine how lease rates are determined for aquatic lands, and whether improvements should be made.

Growth Management Act: City and county compliance with the Act’s 120-day permitting requirement (winter 2023)

The state’s Growth Management Act requires fast-growing counties and cities to develop comprehensive plans and regulations to guide future growth and limit the ecological impact of urban sprawl. To support the goal of predictability in permit processing, counties and cities must also establish time periods for the permit review that do not exceed 120 days. Local governments may make exceptions to the 120-day rule in two circumstances: establishing different timeframes for permit types that are known to take more than 120 days, and extending the timeframe for specific permits with the agreement of the applicant. This audit will examine the extent to which a selection of counties and cities are complying with this 120-day rule. Read the one-page summary (PDF).

No topics currently in the 2021-23 workplan.

Medicaid Managed Care: Ensuring rates paid to MCOs reflect accurate data and program integrity efforts (summer 2023) 

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 2021, these five MCOs received more than $9.1 billion; nearly half of this money went to one MCO. HCA cannot cap enrollment in the program, but it can control costs through program integrity efforts. HCA must also ensure that “encounter data” from MCOs is accurate, because monthly premiums are based on this data and inaccurate data could result in inflated premium rates. This audit will determine whether HCA and the MCOs have effective processes in place to ensure that encounter data is complete and accurate, and if the monthly premium rates HCA pays to MCOs reflect MCO program integrity efforts, such as identified overpayments. Read the one-page summary (PDF).

Improving Administrative Processes and the Nursing and Medical Commissions (summer 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).

Lead Testing for Children Enrolled in Medicaid (fall 2023)

Elevated blood lead levels can contribute to lower IQ and behavioral and learning problems. Blood tests are the only way to confirm if a child has elevated blood lead levels. Federal law requires that children enrolled in Medicaid receive two blood lead tests before they turn two, or once before six years of age if no previous test took place. Washington’s Health Care Authority, as the state’s Medicaid agency, is responsible for ensuring providers perform required lead testing. In addition, the Department of Health tracks test results and acts to connect families of children with elevated levels to needed services. This audit will determine to what extent children enrolled in Medicaid are receiving the required lead testing. If eligible children are not receiving required tests, we will ask why and identify steps the state can take to ensure children at the highest risk receive tests. 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 could evaluate the effectiveness of DOH’s rollout of the COVID-19 vaccine and consider opportunities to improve future public health event responses. Note that our decisions about this audit’s scope will depend on information presented in the final report of the Pandemic After Action Review Task Force. 

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).  

No topics currently in the 2021-23 workplan.

Information Technology: Reducing risk through better IT legacy system management (summer 2023)

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.

School Safety Planning Follow-up (spring 2023)

This performance audit will follow up on recommendations from our 2019 School Safety Planning audit that were developed to improve regional coordination. In 2021, the Legislature funded regional school safety coordinator positions at each Educational Service District (ESD) to increase districts’ use of best practices in school safety.  Regional school safety centers are intended to provide support in many areas of safety including emergency operations, threat assessments and behavioral health supports. Because school safety remains an ongoing concern, this audit will review what steps have been taken within each ESD to improve school safety and identify where gaps persist. Read the one-page summary (PDF).

Dual Credit Programs in Washington (late fall 2023)

This audit will examine the state’s dual credit programs, which allow students to earn high school and college credit simultaneously. Students may take dual credit courses in their high school or in a college setting. Benefits of these programs include giving high school students early exposure to college coursework and reducing the cost of their college education. However, participation varies across student demographics — for example, students from low-income families and English Language Learners are less likely to participate. A separate issue is the sometimes challenging process of transferring dual credit to higher education institutions. This audit may evaluate opportunities to close participation gaps. It may also examine to what extent colleges and universities in Washington accept dual credits earned in these programs.

K-12 Education: Lessons learned from the COVID-19 pandemic (fall 2023)

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. Read the one-page summary (PDF).

Civil Asset Forfeiture in Washington (fall 2023)

Civil asset forfeiture laws allow 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, including police departments, sheriff’s offices and drug task forces, may seize property even if the property owner has not been arrested, charged or convicted. This audit will examine civil asset forfeitures at a selection of agencies to better understand the characteristics of the civil asset forfeitures they conduct. The audit will also identify any opportunities to address due process concerns.

No topics currently in the 2021-23 workplan.