A U D I T R E P O R T. Audit of Lee County Health Department

Transcription

1 A U D I T R E Audit of Lee County Health Department P O R T Internal Audit Department Audit Number July 3, 2013

2 July 3, 2013 The Honorable Linda Doggett Clerk, Lee County Re: Audit of Lee County Health Department Dear Ms. Linda Doggett: The Internal Audit Department has conducted an audit of Lee County Health Department, Tim Parks, CIA has completed this review. The response to the auditor s conclusions, issues and recommendations are attached to this report. The auditor wishes to thank the Lee County & State employees for their assistance and cooperation during the review. This Report has been posted to the Clerk of Courts website under Internal Audit, Audit Reports. The hyperlink to the report has been sent to the Lee County Board of County Commissioners and appropriate parties. Sincerely, Chuck Short, Chief Internal Audit Officer Internal Audit Department CTS/mf

3 Table of Contents Audit of Lee County Health Department Page Introduction 1 Conclusions 1 Background 1-4 Issues & Scope 4-5 Response 6-8

4 Audit of Lee County Health Department Introduction The Internal Audit Department has conducted an audit of the Lee County Health Department (CHD). The scope of the audit (Exhibit I) included a financial review of the county funds that are provided to the Department on an annual basis. The audit also included a review of compliance with Florida statutes and laws, and compliance with the mandatory contract between Lee County and the State. The audit was performed by Tim Parks, Certified Internal Auditor. Hours 66: Cost $ The audit was performed in accordance with general auditing standards for the professional practice of Internal Auditing. Audit work paper files contain details supporting the findings, conclusions and recommendations in this report. Conclusion Lee County and the CHD are in compliance with Florida Statutes and the contract that governs the contributions that the County makes toward certain programs administered by the CHD. The programs that are paid for by direct contribution are monitored and reviewed by the Lee County Department of Human Services. A review of the list of CHD fleet vehicles revealed that seven of 59 cars and trucks were licensed as County owned vehicles, but they were not included within the fixed asset system that is maintained by the Lee County Clerk of Court. Background Statutory Mandated Services The Florida Department of Health operates the Lee County Health Department. The CHD is responsible for the public health and safety of the residents of Lee County. Florida Statute provides the legislative intent that public health needs be provided through contractual arrangement between the state and each county. The CHD is mandated to provide three levels of service within each county: 1

5 Environmental health services Communicable disease control services Primary care services There is no mandated amount that the county is required to contribute to the CHD. Lee County has provided direct contributions of $1,975,872 to the CHD during fiscal years 2012 and That amount was a reduction from the $2,079,865 that was contributed during the prior three fiscal years. Lee County averaged 9.2 percent of direct payment support to the CHD during the past five fiscal years (see chart below). The percentage is higher than the 7.5 percent average from the previous ten years as noted in the prior internal audit report that was released in All of the CHD employees are employed by the State. There are approximately 237 full time equivalent state employees and 29 other personnel services employees that work for the CHD. 2

6 Contract between Lee County and CHD Lee County entered into the current contract with the CHD for fiscal year 2013 in October, The County appropriated $1,975,872 as the direct contribution to the CHD, not including fees, other cash or local contributions. The monies were divided between six different programs within the CHD including: Women s health services (37.2%) Immunizations (17.5%) Community TB program (9.5%) Chronic disease program (3.9%) Communicable disease surveillance program (11.7%) Sexually transmitted disease program (20.2%) The County also contributes in-kind payments that were budgeted at $315,115 for fiscal year The payments are for such things as janitorial services, utilities, building and parking rental, and self-insurance payments. A third source of county funding includes certain county authorized fees that are collected from the public for services rendered by the CHD. The CHD collects and retains the various fees as well as the interest earned within a trust fund established exclusively for Lee County. The total budgeted direct contributions and in-kind payments for fiscal year 2013 are $2,290,987. The total of cash, in-kind contributions and other contributions was budgeted at $4,956,947. Lee County monitors the program with a Contract Specialist and a Program Manager that work within the Department of Human Services. They completed a review of the CHD as of June 20 th and concluded that, There are no findings or concerns as a result of this monitoring. Comparison with other counties Lee County directly contributed $1,975,872 to the CHD for FY The per capita amount is $3.00. Compared to seven other Florida counties with the closest populations, Lee has the third highest total contribution. Direct per capita donations range from $00 (Hardee County) to $13.10 (Nassau County). The average per capital direct contribution for the entire state is $1.94. County Direct Contribution Population Per Capita Seminole $ 807, ,452 $ 1.86 Pasco $ 76, ,442 $ 0.16 Volusia $ 1,775, ,841 $ 3.52 Brevard $ 467, ,245 $

7 Polk $ 379, ,881 $ 0.60 Lee $ 1,975, ,657 $ 3.00 Duval $ 796, ,004 $ 0.91 Pinellas $ 3,184, ,168 $ 3.47 Average $ 1,183, ,461 $ 1.87 Issues County Owned Vehicles Per the contract between Lee County and the CHD, All vehicles will be transferred to the ownership of the County and registered as county vehicles. A review of the list of CHD fleet vehicles revealed that seven of 59 cars and trucks were licensed as County owned vehicles, but they were not included within the fixed asset system that is maintained by the Lee County Clerk of Court. It is recommended that the CHD reconcile the list of vehicles with the Finance Department of the Clerk of Court. 4

8 Exhibit I Audit Scope The scope of the Lee County Health Department audit includes: Financial review of County funds provided to the Lee County Health Department on an annual basis Compliance with the contract that is mandated between Lee County and the State Compliance with applicable Florida Statutes and laws 5

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