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Kansas Legislative Division of Post Audit

Agency Responses to Audit Recommendations

Previous Audit Recommendations Agency Updates as of May 2020
Audit Report ID Recommendation Current Status Description of Current Status
Department of Corrections
Kansas Department of Corrections: Evaluating the Use of Former Honor Camp Facilities (2017) 1 Because the federal government is unlikely to allow KDOC to permanently keep the facilities vacant, KDOC should develop and implement a plan to demolish the two vacant honor camp facilities and restore the grounds. The plan should include the financial resources it would need and a timeline for demolition and restoration. Expired N/A
Office of Information Technology Services
Office of Information Technology Services: Reviewing the Office’s Service and Rate Structures (2018) 1a OITS should include all prior-year balances in its models. Have Implemented Prior-year balances will be considered in the future as rates are being developed.
1b OITS should periodically review the accuracy and completeness of its rate models. Have Implemented Rates are reviewed on an annual basis.
2a OITS should develop a plan for improving its rate setting process to address: i) how to balance OITS’ need to periodically adjust rates to cover its expenses against agencies’ needs for budget stability, ii) how to streamline, eliminate, or otherwise cover OITS’ expenses for services that consistently operate at a loss, and iii) any other obstacles that currently prevent OITS from setting service rates equal to those produced by its rate-setting model. In Progress The review process by OITS of the rates charged for services provided is currently underway. This review, along with proposed recommendations and revisions, will be completed in time for the Division of Budget to include them in their FY22 Budget Instructions which are scheduled to be published around July 1, 2020.
2b Present the final plan to the Legislature for their consideration by April 2019. In Progress Rates will be published before July 1st, 2020, and will be presented to the legislature at the appropriate time.
Department on Aging and Disability Services
Community Mental Health: Evaluating Mental Health Services in Local Jails (2018) 1 To address the problems associated with recommended mental health services in Kansas Have Implemented KDADS convened a group as described in previous updates. They created a 2020 state action plan. As part of that plan, KDADS proposes an 18-month collaboration with the Council of State Governments-Justice Center to support communities across the state in reducing mental illness in jail through participation in the Stepping Up Initiative. KDADS will support this project at the state level with cross-system collaboration with key partners from the state and local agencies. Among other things, this would include creating a Kansas Stepping Up Technical Assistance Center.
1a Work with the Legislature, local sheriffs, and community mental health centers to develop a statewide plan. The plan should include the following components: Have Implemented See above
1ai what agencies or entities should be responsible for providing necessary mental health services to inmates Have Implemented Nearly all jails in Kansas reported identifying suicidal inmates and providing needed medication. Kansas statute directs jails to provide for the safety and medical care of individuals while incarcerated. By providing direct technical assistance, access to training and a central information resource, the Kansas Stepping Up Technical Assistance Center will enable participating jails that did not report screening and assessment to incorporate those services as needed.

In state fiscal year 2020, the position of Jail Liaison is new to the agreement between Community Mental Health Centers and KDADS. The Jail Liaison is a designated representative from the local CMHC who will work directly with inmates and jail staff to assist with accessing information and resources and provide the supportive services and follow up for treatment and discharge to the community. The CMHC will provide these services to the jails in its geographic catchment area, regardless of the pre-incarceration residence of the inmate. The Kansas Stepping Up Technical Assistance Center, supported by KDADS, will engage both local law enforcement, county leadership and local providers to find solutions for individual communities to further sustain this work. In addition, KDADS will continue to pursue additional resources to support the CMHCs.
1aii the types of mental health services that should be available to inmates in Kansas jails Have Implemented The Kansas Department for Aging and Disability Services supports the six core services the National Commission on Correctional Health Care’s 2015 Standards for Mental Health Services in Correctional Facilities as identified in the LPA report; Suicide Prevention Program, Mental Health Screening, Mental Health Assessment and Evaluation, Medication, Treatment, and Discharge Planning. KDADS also recognizes the positions of the Kansas Sheriffs’ Association and the Association of Community Mental Health Centers of Kansas that do not support a mandate for specific services. The proposed Kansas Stepping Up Technical Assistance Center will work directly with local counties to develop individual plans that fit the needs and resources of that county. These individual plans will address the implementation of the six core services as best fits the local community.
1aiii what and how much mental health training should be provided to all jail staff statewide Have Implemented Like resources – training needs are specific to the jurisdiction. The Behavioral Health Services Commission (BHS) recognizes the feedback from the workgroup that smaller departments and law enforcement agencies don’t have the capacity to divert corrections or patrol staff to lengthy trainings, like the 40-hour Crisis Intervention Training. BHS will continue to work with the Kansas Law Enforcement Training Center, Mental Health America of the Heartland, Kansas CIT Association, and the Association of Community Mental Health Centers of Kansas to make accessible a range of trainings to local law enforcement.

In addition, the Kansas Stepping Up Technical Assistance Center will provide intensive local support to participating communities, the opportunity for peer-to-peer learning with other agencies, national expertise and resources, and a central information bank with ongoing access to resources and broad-based TA on issues around mental illness and the justice system for all Kansas counties.
1aiv what resources are needed to fund the services and training that are determined necessary Have Implemented To implement this plan, KDADS needs the funds to contract with the Council of State Governments – Justice Center to develop the Kansas Technical Assistance Center. A central component of the Stepping Up Initiative is developing local leadership commitment to providing resources as well as assisting in identifying funding strategies specific to a community. In addition, the workgroup requested additional support to CMHCs for the provision of a Jail Liaison to coordinate treatment and discharge services for inmates with mental illness. Public funding restrictions prohibit CMHCs from being able to bill KanCare for services provided to individuals while incarcerated.

Quick access to care in the community following discharge from jail is crucial to helping Kansans with mental illness continue to maintain community tenure. To ensure that individuals with KanCare benefits prior to incarceration are quickly connected to services, the Kansas Department for Health and Environment – Division of Health Care Finance recently began to contract with Appriss data exchange company to provide real-time information on the incarceration status of KanCare members. Appriss provides a nightly file match of all bookings and releases from county jails across Kansas to KDHE. KDHE is then able to reinstate the benefits of eligible members after release or approve MediKan Reintegration and send a new benefits application. According to KDHE, benefits are reinstated or MediKan is established within 24-48 hours from release. KDADS will continue to work with KDHE and CMHCs to ensure this process effectively provides seamless access to services.

Finally, KDADS supports the continued development and implementation of recommendations made in the Mental Health Task Force Report presented to the Legislature in January of 2019. A robust continuum of care in the community is necessary to achieve a reduction of mental illness in jail. Closing the gaps in the mental health system identified in the task force report will create avenues for Kansans to receive the services they need before jails become the provider of last resort. Since the release of the LPA report, additional crisis centers have opened across the state with more in development. Effective mental health treatment in jail can only be sustained when there are community resources available after release.
1av mechanisms for jails and community mental health centers to better coordinate services before inmates are released from jail Have Implemented The inclusion of the Jail Liaison position in the KDADS agreement with CMHCs will improve coordination of services for inmates as they return to the community. The Jail Liaison will be able to ensure continuity of care and assist the individual in obtaining medication and services in the community. The Kansas Stepping Up Technical Assistance Center will be able to provide support to communities as they build services tailored to the available resources of the community. In addition, peer-to-peer learning will enable communities to learn from Innovator Counties that have found effective local solutions.
1avi what statutory changes may be required to implement the statewide plan Have Implemented No statutory changes are required to implement this plan.
1b Present the final plan to the Legislature for their consideration by July 1, 2020. Have Implemented KDADS is making the report available on our website.

KDADS also reports to the Robert Bethell Oversight Committee and we could present a summary of the plan at their next quarterly meeting upon their request. We also can forward it to the appropriate Legislative Chairs.
Ethics Commission
Lobbying Services: Evaluating a Small Sample of Local Governments’ Reported Payments to Lobbyists and Associations with Lobbyists (2018) 1 To address the issue of lobbyist’ discretion on their public fun reports as described on page D-1, the Ethics Commission should provide additional guidance to registered lobbyists on what constitutes lobbying services and therefore what public funds received lobbyists should report. Have Implemented This item has been fully implemented. Additionally, for maximum clarity to the lobbyists, we are sending specific further guidance to the lobbyists when we send a reminder for the Public Funds Report.

The Ethics Commission issued a formal opinion on this subject in October 2018 located here. This opinion provides that additional guidance.

Additionally, the Ethics Commission will be sending a condensed form of this opinion to lobbyists when we send reminders regarding the Public Funds Report. The Report is due at the end of the calendar year, and as such, would be most effective to send closer to the deadline near the end of the year.
Department of Health and Environment
Medicaid: Comparing Health Care Provider Tax Revenues to Increased Provider Reimbursement Rates (2018) 1 To address HCAIP’s percentage distribution problem, KDHE and the HCAIP panel should: In Progress
1a Modify how HCAIP funds are distributed to ensure hospitals and non-hospital providers receive percentages that align with statute. In Progress New HCAIP funding and structure was passed as statute during 2020 legislative session; KDHE continues to work with CMS to gain approval of new HCAIP program. Old program funding and spending will continue to be in place until CMS approval is obtained.
1b Proactively monitor HCAIP fund expenditures to ensure HCAIP distribution percentages align with statute each year. Have Implemented Agency providing monthly reporting, breaking down total spend, as well as spending by category. Authority to change distribution methodology lies with HCAIP Panel, so is outside of Agency control.
2 To address HCAIP’s overspending problem, KDHE and the HCAIP panel should: In Progress
2a Work with the Kansas Legislature to determine whether HCAIP is intended to be supplemented with state general funds. In Progress Legislature has given proviso to continue program at current spending levels (including SGF subsidies) for last three legislative sessions, including the 2020 legislative session. During 2020, in addition to the proviso, KDHE is to work to obtain CMS approval of new HCAIP program; KDHE is still awaiting approval from CMS. Legislation for new program is clear that the fund is to be State revenue neutral.
2b If not, develop a plan to ensure state general funds are fully reimbursed each year. This plan might include: In Progress Legislature has placed proviso in budget bill for each of the past three legislative sessions to maintain spending at the current levels, including SGF subsidies.
2bi Increasing revenues by raising the percentage and updating the base year used to calculate hospitals’ annual tax payment amounts In Progress KDHE awaiting formal approval from CMS to move to the new HCAIP program, which would be State revenue neutral. Increase of assessment on hospitals is part of the new proposed structure.
2bii Increasing revenues by using both net inpatient and outpatient revenues to calculate hospitals’ annual tax payment amounts In Progress KDHE awaiting formal approval from CMS to move to the new HCAIP program, which would be State revenue neutral. Addition of outpatient hospital revenues is part of the new proposed structure.
2c Proactively monitor HCAIP fund expenditures to ensure state general funds are fully reimbursed each year. Have Implemented Legislature has placed proviso in budget bill for each of the past three legislative sessions to maintain spending at the current levels, including SGF subsidies.
2biii Decreasing expenditures by reducing HCAIP’s Medicaid payment rate increases or the payments made to hospitals to help cover services provided to uninsured patients. Will Not Implement 2019 Legislature appropriated funds to allow program to spend in excess of revenues for SFY20. Legislature also increased tax base, which will lead to fundamental changes in program; program is to be state budget neutral in the out years. Once the changes are approved by CMS, agency will re-structure how the payments are made, per HCAIP panel guidance.
2d Present their plan to the Kansas Legislature for its consideration no later than July 1, 2019. Have Implemented 2019 Legislature appropriated funds to allow program to spend in excess of revenues for SFY20. Legislature also increased tax base, which will lead to fundamental changes in program; program is to be state budget neutral in the out years. Will require further action by the 2020 legislature, as the changes were made by way of proviso, so authority technically expires on June 30, 2020.
Kansas Department of Agriculture
Department of Agriculture: Evaluating the Animal Facilities Inspection Program (2018) Q1R1 Program officials should update their policy and procedure manual to correct deficiencies we identified in this question related to consistent inspections and appropriate penalties. In Progress The policy and procedures manual is 75% revised. When completely revised, the manual will be reviewed by the Agency Legal Team, Agency Administration and the Pet Animal Advisory Board. The goal date to have this ready for review by May 15th. The legal matrix policy has been developed, reviewed and approved. It is officially implemented. The policy has been distributed to the Pet Animal Advisory Board and inspectors are reviewing the new policies with facilities as they are inspected.
Q2R1 Program officials should create processes and policies to: Have Implemented
Q2R1a Establish annual performance goals for inspectors. Have Implemented Performance reviews for 2019 have been completed. As soon as the Program can return to normal operation, mid-year reviews will be completed.
Q2R1b Monitor that all inspections and penalties are timely and appropriate. Have Implemented The AFI Program worked with KDA Information Technology Division to develop and implement a real-time electronic reporting and scheduling monitoring tool. This tool provides suggested dates of routine inspections, inspection overdue lists and aids inspectors in developing weekly schedules.
Q2R2 Program officials should work with Kansas State University officials to provide the statutory required training. Have Implemented The program organized and held a one day training with Dr. Brad Crauer, Kansas State University College of Veterinary Medicine, during our annual staff meeting this past July. This was attended by the program inspectors as well as the division field veterinarians. As mentioned in the last report, the AFI sponsored Small Animal Seminar was held this past June. This seminar is directed to the licensees but provides opportunities for continuing education for the AFI staff. We are actively seeking more training opportunities and have developed an annual training plan with the KSU College of Veterinary Medicine.
Q2R3 Program officials should consider working with the Legislature to request an investigative inspector position. In Progress A position description has been developed and the job announcement was published. But the unforeseen implications of the COVID pandemic has put a temporary hold on filling this position per the direction of the Kansas Division of Budget. As KDA assesses our future budget status and the state-wide suspension of non-essential Covid response new positions has been rescinded, we will move forward with filling the investigator position.
Department of Administration
State Surplus Property: Evaluating Opportunities to Generate Revenue from State Owned Land and Buildings (2019) 1 The Department of Administration should work with officials from the Adjutant General’s Department, the Department of Corrections, and the Kansas Commission on Veterans Affairs to determine if they agree that the four properties we identified are surplus and if they should be sold. In Progress The Department of Administration (DofA) has spoken with the Department of Corrections and they have expressed no interest in selling the properties identified. DofA will follow-up with the other agencies in the coming months to determine their interest in selling the properties identified.
2 The Department of Administration should develop criteria for identifying surplus real property and make existing guidance for selling surplus real property available to state agencies to use. They should also develop a process for periodically reviewing state owned real property to identify surplus property. In Progress DofA has developed the steps to identify and dispose of surplus property. Furthermore, DofA will reach out to state agencies every five years to determine if the agencies have an interest in selling any property they have deemed surplus.
Department of Commerce
Kansas Department of Commerce: Evaluating the Department’s Administration of the Job Creation Program Fund (2019) 1 The Department of Commerce should establish criteria it will use to evaluate job creation fund awards and a process for determining how much money it will award. Have Implemented Commerce evaluated JCF awards based on the economic impact to the community, county, region and state of each business recruitment/business growth project. Economic impact was based on the number of new/retained jobs, salaries and wages of those jobs, and the new capital investment created by each project. Commerce also evaluates the competition from other states for each project. Commerce also evaluates how the state’s JCF investment leverages local incentives in partnership with local units of government.

Commerce continues to evaluate projects as stated above but Commerce also utilizes an internal committee inclusive of the Secretary, the Deputy Secretary, Legal Counsel and Business Development Director to ensure the worthiness of a JCF award and that those awards are aligned with statute.
2 The Department of Commerce should verify that the data companies submit related to award requirements is accurate. Have Implemented Companies awarded JCF file annual reports that include job creation. Commerce compares those reported numbers against data available from the KDOL to ensure accuracy and proper oversight. The annual reports also provide evidence of purchase orders, invoices and receipt that verify the capital investment made by the company. Companies sign a contract with the State of Kansas/Commerce in which they attest, under penalty of law, that their reporting accurately reflects their job creation, payroll and capital investment. Commerce does not have the staff resources to visit each company to verify information contained in the annual reports. Much of the verification process outlined in this response was omitted in the LPA audit.

Commerce continues the verification process outlined above and believes it is more than adequate to assure companies are delivering on the contractual obligations for job creation, payroll and capital investment. The fact that Commerce has deployed clawbacks when metrics and expectations are not met is further evidence that the verification system is working.
3 The Department of Commerce should include all elements in its annual report required by state law and seek out any legislative guidance it needs to understand those requirements. Have Implemented Commerce reports to the Legislature annually via regularly scheduled testimony provided to the Senate Commerce Committee, Senate Ways & Means Committee, House Commerce/Economic Development/Labor Committee, House Appropriations Committee, House Rural Revitalization Committee and other Committees as requested. Commerce also appears before Interim Committees as requested to provide agency information, reports and program information. Commerce publishes an annual written report that covers aggregate program information.

Commerce has deployed a new public-facing program award database that is published on our website and updated to ensure it is current. This database includes awards from all our programs once those awards have a signed contract and the information shared is no longer considered proprietary and confidential. You can find the transparency database by following this link. Further Commerce is re-formatting our published annual report to ensure it is a comprehensive review of programs and incentive awards. This annual report will be made available electronically to Legislators and the general public in the fourth quarter of each calendar year.