By Hank Russell
New York State bought hundreds of millions of dollars worth of medical equipment at the onset of the COVID-19 pandemic, including ventilators and x-ray machines, that now sits unused in storage facilities across the state, missing recommended maintenance and costing taxpayers storage expenses, according to an audit released on April 10 by State Comptroller Thomas P. DiNapoli.
“During the pandemic, New York state quickly purchased medical equipment to address the public health crisis,” DiNapoli said. “Now, hundreds of thousands of unused devices sit idle. I urge the Department of Health to develop and execute a strategic plan for the maintenance and use of these and future medical equipment purchases, so New York is well prepared for the next public health emergency.”
To compete for the purchase of durable medical equipment (DME) at the start of the pandemic, the state took emergency steps to accelerate its procurement process, inconsistent with Office of General Services (OGS) guidance. According to the Department of Health (DOH) and OGS, procurement orders during the onset of the pandemic were determined by the former Executive Chamber with assistance from a consultant who was responsible for projecting the quantity of DME the state would need to respond to COVID-19.
DiNapoli’s auditors determined the state paid $452.8 million to purchase 247,343 items of DME and received 51 items donated by others or from the federal government, for a total of 247,394 items procured during the onset of COVID-19. Of the total DME available for use (including pre-COVID-19 inventory), only 324 items were distributed during the public health emergency, and only three items from the 247,343 DME purchased during COVID-19.
DME now in storage includes CPAP/BiPAP machines, ventilators, oxygen tanks, pulse oximeters (which measure the saturation of oxygen carried in red blood cells), oxygen concentrators, and infusion pumps.
When the public health emergency ended, a Medical Stockpile Steering Committee was created to make recommendations on what quantity and type of DME should be retained in the emergency stockpile. The committee recommended DOH retain 51,140 DME items, and that 4,468 items should receive scheduled preventive maintenance, leaving almost 200,000 DME items without a plan for utilization. DOH could not provide auditors with documentation supporting how the steering committee reached their decisions, leaving auditors without a way to assess the committee’s conclusions.
Auditors found that DOH began to identify ways to reduce its inventory as COVID cases decreased, but did not finalize a process or create written procedures. Auditors determined limited action was taken to reduce the stockpile. DOH conducted some surveys of the medical community, with facilities expressing interest in 24,585 DME items, but very few items were sent to the medical facilities.
Auditors also found a lack of controls during the pandemic contributed to DOH being unable to account for all the DME purchased, with credit card transactions an issue. Looking at a sample of nine credit card purchases, auditors found DOH could not provide proof of delivery for four purchases which included 140 pieces of DME worth $312,644. The audit notes that the Department of Homeland Security and Emergency Services and the New York National Guard may have purchased, stored or transported DME, as well as confirmed if equipment was received during the early stages of the pandemic.
Early in the pandemic, DOH contracted with a vendor to perform initial inspections of the DME, as well as preventive maintenance and repairs on certain equipment. Auditors found that the contract ended in December 2023, and DOH had not secured another contractor. As of December 2024, 4,036 of the 4,468 DME items recommended to have scheduled preventive maintenance were overdue. That could affect product warrantees and risk additional costs to the state for repairs that could have been covered. In addition, failure to maintain DME increases the risk that equipment will need more costly repairs or will not be ready for emergency distribution or function if needed.
DiNapoli’s office made the following recommendations to the DOH:
- Maintain basic internal controls during emergency scenarios to ensure stewardship over State assets that address concepts such as conducting transactions in an ordinary manner, recording transactions, effective communication, and documenting receipt of purchases.
- Document and preserve the process and/or key factors used when making significant decisions, and keep documentation of key events, such as the Steering Committee’s recommendation of DME to be retained and to receive preventive maintenance.
- Develop and implement a statewide public health strategic plan to utilize surplus DME.
- Develop and implement a strategic plan for DME preventive maintenance so that it is ready and reliable for use during public health emergencies.
In response, the DOH said it “maintains appropriate internal controls and processes to maintain appropriate stewardship over State assets”; “conducts surveys of healthcare facilities to assess needs and interest level specific DME…”: and “conducts preventive maintenance programs pursuant to manufacturers’ recommendations.” The DOH noted that access to the warehouses is at the discretion of the warehouse owners.
The following recommendation was made to the OGS:
- Develop and issue statewide guidance for State agency procurements during declared State emergency disasters in conjunction with the State Procurement Council.
The OGS agreed with the recommendation. However, the comptroller’s office replied that the agency’s guidelines “do not institute an agency’s responsibilities during a dedicated State disaster emergency — particularly when the duration of the disaster extends beyond a one-time emergency situation.”