This audit of the Department of Social Services and Department of Health and senior Services was released on December 15, 2018 by the Office of Missouri State Auditor. The objectives of the audit were to: Analyze data on home- and community based services (HCBS) authorized and paid, and evaluate the key factors influencing the data. Determine the factors that have caused growth in participation and costs related to HCBS. Determine whether the change in nursing facility level of care (LOC) is having the intended effect. Evaluate the economy and efficiency of certain . . .