Audit faults grant, ventilator distribution in Wisconsin during height of COVID-19

A state audit released Wednesday faults the Wisconsin Department of Health Services for how it awarded grants and ventilators to health care providers during the height of the COVID-19 pandemic.

The agency’s leader, in her response, defended the awards, emphasizing that the money and ventilators were handed out during a public health emergency with the goal of keeping health care providers open and able to provide care to patients.

The nonpartisan Legislative Audit Bureau reviewed documentation for 31 grants totaling $3.2 million that were a part of nearly $160 million in grants the state agency distributed between the start of the pandemic in March 2020 through June 2022. The money went to long-term health care and emergency medical services providers who were on the front lines of the pandemic.

The audit said 10 grant recipients awarded $518,700 did not submit sufficient documentation to support their applicants or the amounts requested.

Kirsten Johnson, the state health secretary, said in her response letter that the programs reviewed “were implemented during highly unusual circumstances of the public health emergency.”

“DHS was required to make quick decisions to provide funds to the long-term care, emergency medical services, and hospital providers, who needed them to continue to provide care during this critical emergency,” Johnson wrote.

She said the agency disagreed with the audit’s findings that documentation collected by DHS from the grant recipients was insufficient to prove need during the COVID-19 crisis. Agency staff “had significant back and forth communication with providers to ensure we were comfortable with the level of documentation to support funding requests” at a time it was trying to ensure providers could remain in business, Johnson said.

However, the agency will take the corrective steps recommended in the audit, including seeking additional documentation from the grant recipients, Johnson said.

The audit also faulted how DHS handled distribution of more than 1,500 ventilators the department purchased and maintained for nearly $39 million during the first two years of the pandemic. The ventilators went to hospitals, fire and rescue departments, and emergency medical services providers.

The audit said the health department did not execute loan agreements with everyone who got ventilators, did not inventory the ventilator-related equipment it purchased, did not regularly track whether the ventilators had been maintained by the firm with which the agency contracted, or develop a plan for the future use of the ventilators.

Six ventilators, with a combined value of $122,300, were missing as of January, the audit said.

Distributing the ventilators during the emergency response at the start of the pandemic, combined with high staff turnover, made the agency’s job difficult, Johnson wrote in her response.

“Auditing a program established in these conditions, but assuming optimal conditions, fails to account for the dynamic nature of the emergency that DHS staff along with other state partners navigated,” she said.

The agency agrees with the audit’s recommendation to develop a plan for future use of the ventilators, Johnson said.