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 today 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.

State Spent Hundreds of Millions on Medical Stockpile but Used Little

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.

No Clear Plan for Equipment

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.

Lack of Controls and Preventive Maintenance

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.

Recommendations

DiNapoli’s audit recommended DOH:

• Maintain basic internal controls during emergency scenarios to ensure stewardship over state assets;
• Document and preserve the process and key factors used when making significant decisions, and keep documentation of key events;
• Develop and implement a strategic plan for DME preventive maintenance so it is ready to use during public health emergencies;
• Develop and implement a statewide public health strategic plan to utilize surplus DME.

DOH responded to the audit’s statements and audit findings.  OGS agreed with the one recommendation made to the agency.  Their responses are included in the audit.

Audit
Department of Health/Office of General Services: State Public Health Emergency Medical Stockpile