Audit slams state's fumbled response to 3 major outbreaks

HONOLULU (HawaiiNewsNow) - The state Health Department experienced "communication breakdowns" and "inconsistent processes and procedures" in its response to three disease outbreaks in 2015 and 2016, a scathing new audit found.

In the 46-page report released Thursday, the state Auditor's Office reviewed the response to the dengue fever outbreak on Hawaii Island, the Hepatitis A outbreak on Oahu and Kauai, and salmonella-infected ogo on Oahu.

The audit found that during the outbreaks, the Department of Health didn't have a basic communications plan, including on when to announce the outbreaks and how to share information with other agency officials.

The communication problems may have caused confusion and discord during the state's response to the outbreaks, the audit said.

"These deficiencies result in limited accountability to the public and could also result in missed investigation steps and possible delays and/or replication of efforts during an outbreak response," the state Auditor's Office said, in the report.

The audit also found that the Disease Outbreak Control Division was inconsistent with its recordkeeping, internal review, and reporting.

Auditors said the Health Department couldn't provide a timeline or summary of the outbreak responses, and the outbreak control division did not follow its own disease-specific protocols.

State Auditor Les Kondo said the department's lack of plans and recordkeeping meant that health officials had to "reinvent the wheel" for each outbreak response.

"DOH and the Division, as state agencies, are accountable to the Legislature and the public, which requires, among other things, that they collect and maintain proper records," Kondo said, in a news release. "But just as important, proper recordkeeping preserves institutional memory, so agency officials — and those who succeed them — don't have to continually reinvent the wheel."

The state health director Dr. Virginia Pressler says the findings aren't surprising and she agrees there's room for improvement.

"It became clear to me as soon as the Dengue outbreak happened that there was a major issue with communication. Those three outbreaks, right on top of each other, really stretched the resources of the branch," Pressler said.

Pressler says well before the audit happened, the department was already making changes, such as using federal dollars to create a statewide response plan for mosquito-borne diseases, as well as a significant reorganization of the department where the director will now oversee response efforts.

"Moving the activities to the director's office makes it easier to gather resources from throughout the department and to work with other departments," she said.

The health department says it is also working with the State Attorney General's office to determine ahead of time what information can be disclosed without violating patient privacy.

The audit was conducted from November 2016 to May 2017.

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