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The Sisyphus Files – Repeated Issues in Performance Audits

Episode One: Data Quality -

Over the course of years, as we’ve closely followed the work of state and local performance auditors, a somewhat bleak thought is with us. These people, whose lives are dedicated to state and local government, find themselves repeating many of the same findings over and over again, as they tackle different agencies and different issues.

It seems to us that they might well identify with the woes of the character from Greek mythology, Sisyphus, who was condemned by Hades to spend endless days rolling a rock up a hill to see it plummet down again, only to start the upward climb once again.

From our selfish journalistic vantage point, however, the woes of the performance auditors have long provided fodder for our work, as we see opportunities for coverage in the drumbeat of common findings in a long-term series of audit reports. The list of issues we’ve seen in multiple audits in recent months just starts with those that refer to unprotected computer access, subpar training, unreliable documentation, incomplete or confusing policies and sloppy inventory controls.

In this special feature, we’re going to focus in on one significant issue that seems to crop up over and over again: shortcomings in data quality. While we’ve seen major improvements in data governance in recent years, problems persist. A few examples: In December, a performance audit of the Department of Corrections in Vermont pointed to shortcomings in the basic information collected about the “number, type, status, or outcome of prisoner grievances”. A Minneapolis audit about internal investigation processes, cited data weaknesses, including problems in “data retention and destruction” guidelines. A King County audit found “Incomplete recordkeeping, a lack of verification, and unreliable data tools” contributing to the fact that a number of temporary employees had been shortchanged on benefits that were due to them.

One common data issue has to do with the adequacy and reliability of information that comes from third party organizations such as nonprofits, community boards or private sector contractors that deliver state or local services. Data requirements are often written into performance contracts, but too often the promises are not delivered.

Take Virginia’s December 2022 report about the behavioral health services delivered by its Community Service Boards (CSBs). While state law provides mechanisms to evaluate performance and hold these boards responsible for delivering behavioral health services, those mechanisms are “rarely used” according to the report from Virginia’s Joint Legislative Audit and Review Commission.

Why? Because the data emanating from the boards aren’t adequate to document consumer experience and the outcomes of the care they receive – problems that inhibit state oversight. As the report summary states, Virginia’s Department of Behavioral Health and Developmental Services “has no formal processes or data to understand critical aspects of CSBs’ service delivery and consumer outcomes, such as preadmission screening or discharge planning.”

Anyone following the sorry state of mental health in this country can immediately see the significance of this finding. Virginia’s community service boards prioritize individuals with serious mental illness and those numbers were 20% higher in fiscal 2022 than a decade before. CSB work is particularly vital in rural areas, where other professional help is be limited.

Another example. In December, the Minnesota Legislative auditor released an report about managed care companies that deliver personal care services. Although the companies generally met legal and contract requirements, “a number of instances of noncompliance” were cited in how they reported “encounter data”, which provides details on the actual visits to clients needing personal care services. That data is used for lots of things, such as how clients are served, rate setting and forecasting future needs.

These are just a couple of examples of the multiple repeat findings that occur in performance audits regularly. That’s why we follow these documents so carefully and know that while they are of particular significance to the individual entities involved as they provide a often neglected view of broader management problems from coast to coast.

This is the first in an occasional series of website features, which we’ll be dubbing “The Sisyphus Files.” Next up: Unprotected computer access.

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