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It’s no small irony that just a couple of weeks after Gov. Kathy Hochul released a final report on New York’s “Master Plan for Aging,” the state comptroller released a scathing audit on the state’s monitoring of adult care facilities.

If anything needs a master plan, it seems to be a state Health Department that too often has been found to be deficient when it comes to safeguarding the health of New Yorkers, aged and not-so-aged.

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The latest critique of the agency came Wednesday from Comptroller Thomas DiNapoli, whose office found that the Health Department was not adequately overseeing the more than 500 adult care facilities around the state, which serve some 37,500 people. The facilities provide housing, meals and personal care for people who cannot live alone but aren’t in need of nursing home care.

The audit, which covered the years 2018 to 2024, found in a sampling of facilities that while the state is supposed to do inspections in a 12- to 18-month timeframe, the Health Department failed to do so 70% of the time. Some inspections weren’t done for five years.

In on-site checks, auditors found a range of serious health and safety issues, including crumbling stairs and walkways, dishwashers that weren’t hot enough and refrigerators that weren’t cold enough, expired medications, and staff members not certified in first aid.

In many cases, auditors found no documentation that the agency had checked to see if violations were corrected, and in many instances there was evidence the violations indeed had not been fixed.

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The department’s track record on handling complaints, including allegations of poor care, was spotty, with a sampling finding that nearly a fifth weren’t investigated.

The department blamed the problems partly on the COVID-19 pandemic, but considering that the audit covered years before and after the pandemic, that excuse only goes so far. As the report noted, since 2021, after the worst of the pandemic was over, the agency was still doing fewer than half the number of inspections it did prior to the outbreak of the virus.

The agency cited a shortage of staff assigned to adult care facilities, which dropped from 104 in 2019 to 79 as of December 2023. The department said it has been recruiting and was up to 89 by August 2024 — still well below the pre-pandemic level.

This has real-world human consequences. As Richard J. Mollott, director of the advocacy group Long Term Care Coalition, put it: “The message is that the operators know that they can get away with really poor care and really bad conditions.”

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And this audit is just the latest indicator of problems at the Department of Health. Audits in 2022 and 2023 raised concerns with the department’s oversight of nursing homes, ranging from undercounting and misleading the public on the numbers of deaths in those facilities to failing to follow up on recommendations meant to improve infection control.

What’s more, the latest audit isn’t the only troubling news even this month.

The state Senate had to cancel a hearing Wednesday on the state’s troubled overhaul of the Consumer-Directed Personal Assistance Program because the very agency handling the transition — the Health Department — wasn’t going to show. The department asked for a delay because it wasn’t going to be able to answer questions at that time, according to lawmakers. The hearing has been put off till Aug. 21.

CDPAP allows people who need help in their daily lives to live independently to select a caregiver who will be paid via Medicaid. Payments used to be handled through hundreds of small home-care companies, but the Hochul administration said that system was rife with fraud and switched to a single vendor. But advocates say tens of thousands of people have yet to be enrolled in the new system, leading to disruptions of care – something the state blames on the clients themselves.

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The Health Department’s request to delay the hearing comes as the state is working on a settlement in a class action case brought by New York Legal Assistance Group on behalf of CDPAP clients. No question settlement negotiations can be sensitive, but that shouldn’t stop the Health Department from being answerable to the Legislature. This transition affects some 250,000 people who use this program, plus their caregivers. If people are confronting obstacles to the care they were promised — essential care that keeps them in their homes — the agency needs to address those concerns right now, not at some point in the future, when it may hope to be able to declare the problems resolved.

And while the Legislature’s at it, lawmakers might want to talk to the agency about its oversight of adult homes.

Which brings us back to Ms. Hochul’s big announcement of a “Master Plan for Aging,” which the Health Department notes is “designed to ensure that older adults and individuals of all ages can live healthy, fulfilling lives while aging with dignity and independence.” For a lot of vulnerable New Yorkers, the aging plan may have to come with big qualifier: Assuming you live that long.