New Jersey Complied With Federal Regulations When Implementing Programs Under SAMHSA’s Opioid Response Grants, But Did Not Meet Its Program Services Goals

Why OIG Did This Audit

The Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), awarded a series of grants to States and Tribes to combat opioid use disorder. These grants included the Opioid State Targeted Response (STR) and the State Opioid Response (SOR) grants. The purposes of these grants were to increase access to treatment, reduce unmet treatment needs, and reduce opioid overdose-related deaths.

Our objectives were to determine whether the New Jersey Department of Human Services, Division of Mental Health and Addiction Services and its subrecipients responsible for implementing SAMHSA's STR and SOR grants complied with Federal regulations and met program goals.

How OIG Did This Audit

Our audit period for New Jersey's STR grant was from May 1, 2017, through April 30, 2020 (the first 2 years of the STR grant and a 1-year no-cost extension). Our audit period for New Jersey's SOR grant was from September 30, 2020, through September 29, 2021, the first year of the grant. To accomplish our audit objectives, we reviewed STR and SOR grant documentation and interviewed New Jersey officials to determine how programs were implemented and whether New Jersey complied with Federal regulations and met grant program goal requirements during the audit.

What OIG Found

New Jersey and its subrecipients complied with Federal regulations by implementing programs under its STR and SOR grants. Specifically, New Jersey funded a new fee-for-service network and expanded opioid treatment services within an existing network of contracted providers. Additionally, New Jersey implemented effective internal controls over its financial administration of grant funds. However, New Jersey did not meet its STR and SOR grant program service goals. According to New Jersey officials, STR and SOR service goals were based on what it expected from providers awarded new contracts and did not consider the length of time it would take to create a new STR provider network or to subcontract SOR services with subrecipients. In addition, for the SOR grant, subrecipients faced challenges with hiring qualified staff and grant activities were impacted by the COVID-19 pandemic.

We recommend that New Jersey identify factors that could delay grant-funded activities when estimating goals for future STR and SOR grant applications.

In written comments on our draft report, New Jersey concurred with our first finding and recommendation and provided information on corrective actions it has taken and planned to take, but did not concur with our second finding. Specifically, New Jersey stated that it reviewed its data and reports and determined that it did, in fact, satisfy projections for the total amount of individuals served by the STR and SOR grants. New Jersey stated that we overlooked certain STR grant data provided by New Jersey during the audit and, for both the STR and SOR grants, New Jersey did not provide certain data to OIG prior to the issuance of the draft report.

After reviewing New Jersey's comments, we maintain that our findings and recommendation are valid. We acknowledge that New Jersey did not provide us with several subsets of data during the audit - despite multiple opportunities to do so - but included those data with its comments on the draft report. We also note that the data provided by New Jersey are summary figures that lack detailed support and have not been reported to SAMHSA. We will review and validate the additional data provided during the audit resolution process.