Performance audit finds Doorway program needs stronger policies, data use and timelier reimbursements

LBA auditors presented the Doorway program performance audit, finding that the state’s network of regional recovery hubs needs improved written policies, better use of client data to measure outcomes, and more timely vendor reimbursements.

John Clinch, the senior performance audit manager, told the Fiscal Committee the audit covered FY2022–FY2025 and reached 12 observations with recommendations. Using the federally required client survey instrument, auditors reported that among responding clients the Doorway program showed a 45.5% improvement in self-reported quality of life after six months; auditors cautioned the survey response set was not randomized and cannot be generalized to all clients.

The audit cited three primary administrative weaknesses: absence of a formal statewide model-of-care framework and associated department policies, incomplete and error-prone monthly output reports, and a protracted reimbursement process that violated contract 30-day payment expectations. The report also identified opportunities to better leverage existing client interview data to measure outcomes and to automate reporting to reduce human error.

DHHS officials present acknowledged the report and said they will work to formalize policies and procedures and pursue data and payment process improvements. "We will prioritize translating contract requirements into department policies and workflow documentation," said DHHS staff who attended the presentation.

The committee accepted the LBA report and placed it on file; members asked for follow-up briefings and suggested the governor’s commission coordinate with DHHS to avoid duplicative websites and reporting channels.

The audit recommended consolidating program materials under a single website, adopting a written model of care that all Doorway sites follow, improving intake and follow-up interview completion rates for federally required measures, and diagnosing root causes of reimbursement delays. DHHS concurred with most recommendations and agreed to provide periodic updates.