Committee asks chairs of boards tied to mental health workforce licensing to explain unaddressed audit recommendations

At a committee meeting, members of the Legislative Budget Assistant committee reviewed a 10-year status spreadsheet of performance audits and voted to ask the chairs of boards associated with the mental health workforce licensing audit to appear before the committee or provide a written response about outstanding audit observations.

The spreadsheet, presented by Christine Young, Director of Audits for the Legislative Budget Assistant office, showed about 30 reports from the last 10 years and highlighted items by color: red rows for audits with few or no updates and green for those agencies reporting full resolution. "You'll notice sometimes there's more than one agency connected to a report," Young said, explaining that one audit may require responses from multiple entities. Jay Henry, Performance Audit Supervisor, guided members through how the spreadsheet records the year released, number of observations, agencies' concurrence status and reported percentage of observations addressed.

Young cautioned members that an agency's claim to have "fully addressed" observations applies only to items the agency agreed with: "When they say they fully address all the observations that really means they fully address the observations they agreed with. It may not mean that they accepted everything we said." Henry added that agencies may "concur," "concur in part" or "not concur," and that the office includes rejoinders in reports when it disagrees with an agency response.

Members pressed on audits tied to the mental health workforce licensing cluster, noting several entries in the red zone with no reported action. One lawmaker said the lack of updates was of particular concern "in a time when everybody seems to agree we have a mental health crisis." Committee members and staff noted practical reasons for slow updates: many of the affected entities are volunteer boards that meet monthly, turnover in leadership, and statutory or organizational changes that move programs between agencies.

As an example of a rapid update, Young said the Prescription Drug Monitoring Program audit had been transferred to the Department of Health and Human Services in February 2021; after the committee alerted HHS staff, the agency reviewed the old audit and produced an updated report—reporting it had "fully resolved 24 of 26 observations," Young said.

After discussion, Representative Lang moved that the committee authorize the chair and the LBA to draft letters to each board chair listed under the mental health workforce licensing item asking that the chair or a designee appear prepared to discuss the outstanding performance-audit observations. The motion was seconded and approved; the committee recorded one abstention. The motion directs the letters to be issued under the committee chair's signature and for audit reports to be attached so recipients know the topics they will be asked to address.

Committee members asked staff to be mindful of scheduling realities for volunteer boards—letters will give at least 30 days' notice, and some boards may respond in writing rather than attend in person. Members said the expected effect is to spur updates and increase compliance with the existing Transparent New Hampshire reporting process tied to the executive order that established audit follow-up reporting.

The committee asked LBA staff to draft the letters using a template already drafted by staff and to circulate the draft to the chair for signature. The committee also instructed staff to move one previously updated item (the HHS prescription program) from the red to yellow area in the spreadsheet.

The committee confirmed that the next regular meeting is scheduled for June 6 in State House Room 100, and asked staff to notify recipients about the letters and to include copies of the relevant audit reports when the letters are sent.