Pandemic Disrupted Addiction, Substance Abuse Services

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(WNY News Now) – An audit conducted by New York State Comptroller Thomas P. DiNapoli reveals that addiction treatment programs in the state were ill-prepared for emergencies during the COVID-19 pandemic, potentially compromising patient care. The audit highlights the need for improved oversight of certified providers and their emergency preparedness plans by the Office of Addiction Services and Supports (OASAS).

Albany – A recent audit conducted by New York State Comptroller Thomas P. DiNapoli has shed light on the significant disruptions in addiction care and services during the COVID-19 pandemic. The audit, which covered the period from 2019 to 2022, revealed that some addiction treatment programs in the state were not adequately prepared to handle emergencies, potentially leaving vulnerable patients at risk of relapse.

The audit specifically focused on the state’s Office of Addiction Services and Supports (OASAS) and its oversight of nearly 400 certified providers who offer essential programs to thousands of New Yorkers struggling with substance use disorders or gambling addiction. The findings of the audit underscore the critical need for improved oversight and monitoring to ensure gaps in patient care do not occur during emergency situations.

During the COVID-19 pandemic, the number of opioid-related deaths in New York skyrocketed by 44% in 2020 compared to the previous year. This alarming increase coincided with a 33% decrease in the number of inpatients seeking addiction treatment. Several factors contributed to the decline in patient admissions, including concerns about contracting COVID-19, restricted visitor access to treatment facilities, court closures, and adjusted enrollment to comply with social distancing guidelines.

The audit identified several key areas in need of improvement within OASAS:

1. Emergency Preparedness Plans: Auditors found that OASAS needs to enhance its guidance for emergency plans in residential or inpatient programs for substance use disorders. Notably, only 14 out of 27 plans reviewed included procedures to address infection control, even though this became crucial in the aftermath of the pandemic. OASAS also failed to review providers’ plans after initial certification, leaving the responsibility of updating them to the providers themselves. Auditors discovered that 71% of the programs they reviewed lacked records to confirm OASAS’ verification of emergency plans or procedures.

2. Locating Patients: The audit revealed that 12% of OASAS’ inpatient or residential programs may struggle to locate missing patients during an emergency because they are not using a required barcode scanning system. Patients in these programs typically wear wristbands with unique barcodes that can be scanned to determine their location and access hospital records. The New York State Evacuation of Facilities in Disasters System (eFINDS) can assist in tracking a patient’s real-time location during emergencies, but the audit discovered that 35 out of 287 programs were not properly set up to use this system. OASAS cited a significant loss of healthcare workers during the pandemic and ongoing staffing challenges as contributing factors to this issue.

3. Waiting Lists: OASAS has not made efforts to improve the accuracy of its waiting list data for certified substance use disorder programs. This lack of accurate data makes it difficult for OASAS to determine which patients in need of care should be prioritized for services. For instance, pregnant women and opioid users are supposed to be prioritized on waitlists. Auditors found that some providers were either not providing the necessary information to OASAS or were sending inaccurate data. Inaccurate data could potentially jeopardize the allocation of resources or skew public data.

In response to the audit’s findings, Comptroller DiNapoli offered several recommendations for OASAS, including the need to review and revise guidance to providers to address disruptions in service, clarify responsibilities related to emergency plans, eFINDS readiness, and waiting list data, and verify that providers have access to eFINDS and are current with staff assignments. He also urged OASAS to improve the use of waiting list data submitted by providers to support better decision-making and oversight.

OASAS responded to the audit by pledging to direct all providers to incorporate newly issued guidance and recommendations into their operations and emergency plans. The office, however, maintained that its guidance to providers during the pandemic was clear. OASAS acknowledged the identified gaps among some providers concerning eFINDS access and waiting list data and committed to reviewing all guidance to ensure clarity and promote compliance.

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