Audit of the Center for Human Development
December 23, 2021 · Center for Human Development · Read the full official report on mass.gov ↗
Published December 23, 2021 Audit covers July 1, 2018 – June 30, 2020 Under Suzanne M. Bump · 2011–2023
source
“CHD did not always properly administer its representative payee function for DMH persons served.”
Read the plain-English breakdown
This is a Massachusetts State Auditor performance audit of the Center for Human Development covering July 1, 2018 through June 30, 2020.
“This report details the audit objectives, scope, methodology, findings, and recommendations for the audit period, July 1, 2018 through June 30, 2020.”
Auditors looked at how CHD handled client money, complaints, and its human rights committee for DDS and DMH group homes and programs.
“In this performance audit, we examined CHD’s compliance with its representative payee1 process for residents of Department of Developmental Services (DDS) and Department of Mental Health (DMH) group homes, examined the complaint processes for DDS- and DMH-funded group homes and programs, and determined whether the duties and membership composition of the CHD human rights committee (HRC) complied with the HRC bylaws and applicable policies, procedures, and regulations.”
These issues matter because CHD served vulnerable people, and weak oversight could affect their rights, complaints, and personal funds.
“CHD offers programs to support a wide range of vulnerable populations, including families in need, children who have been abandoned, and people who have mental illnesses or disabilities.”
If you or someone you care about receives services in a group home or similar program, this audit explains whether complaints and money are being handled with proper oversight.
“The HRC is an independent body, and its general responsibility is to help providers support, promote, and protect the human and civil rights of the people served by CHD, as well as to ensure that the interests of these people are protected in matters of allegations of abuse, mistreatment, or neglect.”
The auditor found repeated control and documentation problems, especially around complaint review and representative payee duties.
“In 52 of 60 instances, CHD did not properly administer the person-served representative payee process.”
The report recommends that CHD put written procedures and monitoring controls in place, and CHD said it was taking steps to improve compliance.
“CHD should document and implement procedures detailing the process for monitoring and reviewing all DDS and DMH person-served complaints.”
The main risk is that people served by CHD might not get full protection when complaints involve abuse, mistreatment, neglect, or their personal money.
“Because they did not ensure that their HRCs reviewed all complaints involving the human rights of persons served, CHD and its subcontractor did not provide a level of oversight that would ensure that the right of persons served to appeal a complaint resolution was adequately protected in matters of alleged abuse, mistreatment, or neglect.”
A representative payee is someone approved to manage Social Security or SSI money for a person who cannot manage it alone.
“The Social Security Administration offers a representative payee program to manage benefit payments for beneficiaries who cannot manage their own Social Security or Supplemental Security Income benefits.”
1 figure(s) pending source verification - not shown
What the Auditor checked
- Did not comply Did CHD administer the Department of Mental Health’s (DMH’s) representative payee function in accordance with its “Person Served Funds Management Policy,” its “Representative Payee Account Policy,” 104 CMR 30.01(4)(a), 104 CMR 30.01(8)(c), 104 CMR 30.01(9)(d), and 104 CMR 30.02(2)?
What the Auditor found
Why it matters: Persons served may not have had adequate oversight protecting their right to appeal complaint resolutions involving alleged abuse, mistreatment, or neglect.
Standard: CHD Human Rights Committee By-Laws, Article II, Section 4(1)(c), and Article VII, Section 1 ( Section 4(1)(c) of Article II of CHD’s Human Rights Committee By-Laws; Section 1 of Article VII of CHD’s Human Rights Committee By-Laws )
2 recommendations
- CHD should document and implement procedures detailing the process for monitoring and reviewing all DDS and DMH person-served complaints.
- CHD should document and implement its oversight procedures to ensure that the subcontractor’s HRC reviews complaints that originate in subcontracted DMH group homes and programs.
Agency response & Auditor reply
Agency: "CHD is engaged in improving its processes to ensure that the Human Rights Committee reviews all relevant human rights complaints pertaining to its DDS and DMH group homes."
Auditor: "Based on this response, CHD is taking measures to address our concerns on this matter."
Why it matters: This created a financial and administrative conflict of interest that could influence HRC decisions.
Standard: 115 CMR 3.09(1)(c) and Section D(2) of Article V of DMH’s Human Rights Handbook ( Section 3.09(1)(c) of Title 115 of the Code of Massachusetts Regulations; Section D(2) of Article V of DMH’s Human Rights Handbook )
2 recommendations
- CHD should establish written procedures that clearly define HRC membership requirements and implement internal controls to ensure that HRC membership composition complies with DDS and DMH requirements.agency: agreed
- CHD should ask DDS or DMH officials for clarity regarding any regulation it finds ambiguous.agency: agreed
Agency response & Auditor reply
Agency: "The Human Rights Committee has accepted the recommendations of the State Auditor."
Auditor: "We agree with the HRC’s decision to no longer allow CHD staff members to serve as members of the committee."
Why it matters: Delayed complaint resolution could prolong adverse conditions, and failure to meet with complainants deprived persons served of the opportunity to participate in investigations.
Standard: 104 CMR 32.04(3)(b), 104 CMR 32.04(3)(d), 104 CMR 32.04(4)(a), and 104 CMR 32.04(4)(c) ( 104 CMR 32.04 )
3 recommendations
- CHD should establish monitoring controls to ensure that timelines are met for 10-day fact-finding investigations and administrative resolutions.
- CHD should establish monitoring controls to ensure that the responsible person meets with the person served or complainant during any administrative resolution.
- CHD should establish monitoring controls to ensure that new employee orientation checklists are completed, have the required signatures, and are retained as evidence that human rights complaint–specific training has been provided to its new employees.
Agency response & Auditor reply
Agency: "CHD is pursuing a comprehensive strategy of enhancing its compliance function."
Auditor: "Based on its response, CHD is taking measures to address our concerns regarding establishing monitoring controls to ensure that timelines are met for investigations and administrative resolutions and to ensure that the responsible person meets with the person served or complainant during any administrative resolution."
Why it matters: Weak oversight could increase the risk of mismanagement, unexplained variances, losses, or theft of funds and left CHD without evidence that expenses were paid correctly or people received personal funds.
Standard: CHD Person Served Funds Management Policy, CHD Representative Payee Account Policy, 104 CMR 30.01(4)(a), and related DMH fund-management requirements ( 104 CMR 30.01(4)(a); CHD’s Representative Payee Account Policy )
2 recommendations
- CHD should document and implement monitoring controls to ensure that check disbursements are not made to staff members from accounts for persons served.
- CHD should document and implement monitoring controls to ensure that all required forms used in the representative payee function for its DMH persons served are on file and up to date; that they have the required initials and signatures and supporting documentation for recurring, periodic, and manual payments; and that funds for personal use are correctly disbursed.
Agency response & Auditor reply
Agency: "CHD has improved some of these administrative processes already by requiring that funds management sheets for individuals served will be scanned into the electronic health record in addition to being delivered to the corporate representative payee."
Auditor: "Based on its response, CHD is taking measures to address our concerns about documenting and implementing monitoring controls to ensure that all required forms are appropriately completed and signed, all payments are supported, and funds for personal use are correctly disbursed."
Why it matters: Weak oversight could increase the risk of mismanagement, unexplained variances, losses, or theft of client funds and left CHD without evidence that expenses were paid correctly or people received personal funds.
Standard: CHD Meadows Homes Policies & Procedures for Individual Funds Management, CHD Representative Payee Account Policy, CHD Corporate Accounting Policy for DDS Funds Management, and 115 CMR 3.08 ( 115 CMR 3.08(10); 115 CMR 3.08(5)(a) )
1 recommendation
- CHD should document and implement monitoring controls to ensure that all required forms used in the representative payee function for its DDS persons served are up to date and have the required initials and signatures, as well as to ensure that personal funds and charges for care are correctly disbursed and supported by the required documentation.
Agency response & Auditor reply
Agency: "CHD will continue to have a robust system of checks and balances to ensure that the funds of individuals it serves as a representative payee are managed properly and that individuals served have money management plans that conform to DDS requirements and are signed by the individual or guardian."
Auditor: "The Office of the State Auditor does not agree that this finding only cites violations of CHD policies and procedures."