NYC COVID-19 Audit Reveals Weak Cost Controls over Testing and Vaccination Sites

The average cost per test was $405, the prices DOHMH paid varied from $202 to $937 per test, a wide range depending on the location. Similarly, the average cost per vaccination per site ranged $169 to a whopping $2,423.

By A Correspondent
New York City Department of Health and dental Hygiene and its vendors opened hundreds of sites across the city for free COVID testing. (PakistanWeek photo)
New York City Comptroller Brad Lander has released an audit of the Department of Health and Mental Hygiene’s (DOHMH) handling of testing and vaccination services during the COVID-19 pandemic. The report, consistent with previous audits, highlights the lack of effective cost controls in the City’s emergency contracting.

The report says the city’s Department of Health and Mental Hygiene primarily relied on vendors to set staffing levels at testing and vaccination sites, instead of implementing a comprehensive monitoring plan with clear standards for assessing contractor performance. “Relying on vendors rather than agency monitoring resulted in inadequate cost controls and inefficient staffing for sites, despite successfully establishing testing and vaccination services in communities most affected by COVID-19,” it added.

The New York City Department of Health and Mental Hygiene’s COVID vaccination sites have been a vital resource in the city’s efforts to combat the pandemic and protect its residents. Located strategically across various neighborhoods, these vaccination sites offered convenient access to safe and effective vaccines for all eligible individuals.

According to the Comptroller’s office, the audit’s review of over $200 million in invoices revealed a significant discrepancy in costs. It said while the average cost per test was $405, the prices DOHMH paid varied from $202 to $937 per test, a wide range depending on the location. Similarly, the average cost per vaccination per site ranged $169 to a whopping $2,423. “Underutilized sites led to huge cost variations and inflated costs when a smaller volume of tests or vaccines were administered,” it added.

“Emergency contracting allows the City to stand up vital services in times of crisis, but demands heightened vigilance to safeguard the fiscal interests of the City. Our audit reveals significant weaknesses in the control mechanisms that impact past, present, and potentially future emergencies. By addressing these challenges head-on, agencies can better spend New York City’s taxpayer dollars wisely and efficiently, even in crises,” said Comptroller Brad Lander.

The report said at certain sites, an excessive number of personnel unnecessarily escalated labor costs. Notably, the audit revealed significant findings: at the eight long-term testing sites, staff only administered a single test approximately every 1.61 hours open, and at the 23 long-term vaccination sites, staff administered one vaccination approximately every two hours.

The report noted that as agencies tackle the pressing humanitarian crisis stemming from the arrival of thousands of asylum seekers and as New York braces itself for future challenges like extreme weather events and health emergencies, City agencies must be prepared to effectively manage emergency spending costs. To accompany the audit, the Comptroller’s Office issued a letter to City Agencies detailing best practices for controlling costs in emergency procurements in the following areas:

  1. Maximize competition in vendor selection to the fullest extent practicable.
  1. Ensure strong contract terms and specific guidance to vendors to track and manage costs.
  1. Conduct robust vendor oversight through contract compliance and enforcement.
  1. Hold vendors accountable for problems, errors, and contract violations during the contract period, in performance evaluations, and in consideration of extensions or renewals.
  2. Track and document spending to ensure maximum reimbursement from state and federal funding sources.

“Our reviews have demonstrated a number of challenges that agencies face in handling emergency contracts, including lack of competition during the selection of vendors, weak contract terms for managing costs, and insufficient monitoring of vendors during implementation.[…] Especially as multiple City agencies deploy emergency contracting to address the humanitarian crisis created by the arrival of tens of thousands of individuals seeking asylum, and as New York City prepares for future crises from extreme weather to future health emergencies, City agencies must be prepared to contain emergency spending costs,” a press release quoted Deputy Comptroller for Audit Maura Hayes Chaffe in the letter to agencies, as saying.

Read the audit of the Department of Health and Mental Hygiene here. Read the Comptroller’s Office’s letter to agencies on vendor oversight and cost containment during emergency procurement here.

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