Texas Did Not Fully Comply With Federal Waiver And State Health, Safety, And Administrative Requirements At All 20 Adult Day Activity And Health Service Facilities Audited
Learn how the AI-generated research projects were createdOverall Conclusion
The State agency did not fully comply with Federal waiver and State requirements in overseeing DAHS facilities serving people with special health care needs, and its inspections were not sufficient to ensure a safe and nonhazardous environment, leaving program participants at risk.
Source Document
Audit Scope
Scope: Of the 422 DAHS providers in Texas during calendar year 2022, 20 providers were selected for audit based on geographic location and number of participants. Unannounced site visits were conducted August 21–24, 2023 in Texas cities including Dallas, Garland, Desoto, Houston, El Paso, Socorro, San Antonio, Brownsville, Harlingen, and Edinburg. The objective was to evaluate whether the Texas Health and Human Services Commission (state agency) complied with Federal waiver and State requirements in overseeing DAHS facilities that serve people with special health care needs who receive services through the 1915(c) Home and Community-Based Services waiver program. The audit did not review the State agency's overall internal control structure or the entire Medicaid program, but focused on internal controls related to the audit objective.
Key Findings Summary
Inspections between 2019 and 2023 identified compliance citations and investigations for most providers.
Texas did not fully comply with Federal waiver and State requirements in overseeing DAHS facilities that serve people with special health care needs receiving DAHS services through the program.
Of the 20 providers audited, 19 did not comply with one or more health and safety requirements.
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AI-Assisted
AI Scope Summary
Assess whether Texas HHSC adequately oversees DAHS providers to ensure compliance with federal waiver and state health, safety, and administrative requirements and to determine whether oversight effectively protects participants.
AI-Generated Insight
This audit highlights significant gaps in regulatory oversight of DAHS providers in Texas, with widespread noncompliance across health, safety, and administrative domains. The large number of noncompliance instances (253) and the dependence on under-resourced inspections underscore the need for strengthened licensure surveys, targeted provider remediation, and ongoing training to protect vulnerable participants.