MADISON, Wis. -

A new audit calls for the Dane County Department of Human Services to streamline work and prioritize programs without an increase in the budget.

Madison-based Baker Tilly presented its findings to county board members and the public Thursday, condensing the 124-page audit into a PowerPoint presentation and highlighting what the the company believed to be the most pressing of its 23 recommendations.

“It really is about figuring out what is it that needs to be prioritized because there is no more money,” Baker Tilly Principal Christine Smith said. “There's no way to make things work differently within the county, given the money that you have.”

For the audit, Baker Tilly surveyed about 70 of the department’s service providers and held focus groups. According to the audit, DCDHS spent more than $150 million on outside service providers, which accounts for more than half of its budget.

Among the recommendations, the group advised the department prioritize programming and make sure providers are paid adequately to maintain high quality of care throughout cost changes.

Steve Strong, with Community Partnerships, said the cost of living issue is a big one. He said as what it costs to take care of those in need rises, payments from DCDHS stay stagnant, which could call for a reduction in service.

“It is frustrating because I know the county budgets for that,” Strong said. “When the costs are going to go up, they budget for that first. And it's not budgeted for the POS (provider) community, yet we're providing the services we were asked to do.”

Strong said he would also like to see more collaboration between providers and DCDHS throughout the entire contracting process. Some of the audit recommendations focused on additional feedback between those agencies and diversifying the providers considered for jobs.

“We have to work together on this,” Strong said.

DCDHS Director Lynn Green responded to the audit, saying the department agreed with most of the findings. At the same time, she said adjusting cost of living payments by 1 percent would cost the county an additional $1 million.

“We all believe in prevention and early intervention, and have fought hard to sustain that, but we're going to have to talk about our ability to continue doing that,” Green said.

The audit also encouraged the department to increase training, establish oversight committees, develop clear lines of accountability, clarify staff roles and implement more consistent processes.

Green said her staff is already working to fulfill the recommended improvements.