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FINDINGS, CONCLUSIONS, AND
RECOMMENDATIONS
PAYMENTS WERE MADE FOR EFFICIENCY INITIATIVE BILLINGS FROM IMPROPER
LINE ITEM APPROPRIATIONS
The Department made payments for efficiency initiative
billings from improper line item appropriations.
Public Act 93-0025, in part,
outlines a program for efficiency initiatives to reorganize, restructure, and
reengineer the business processes of the State. The State Finance Act details that the amount designated as
savings from efficiency initiatives implemented by the Department of Central
Management Services (CMS) shall be paid into the Efficiency Initiatives
Revolving Fund. The Act further
requires State agencies to pay these amounts from line item appropriations
where cost savings are anticipated to occur.
The Department could not provide documentation on any
guidance for the FY04 billings from CMS detailing where savings were to occur
nor did CMS provide evidence of savings for the amounts billed. Department staff reported they had not
experienced any significant savings from the efficiency initiatives.
We found that the Department made payments in FY04 for these
billings not from line item appropriations where the cost savings were
anticipated to have occurred but based on an attempt to spread the payments
across different funds to encompass the Department as a whole. The Department used:
·
$235,000 from a lump sum appropriation to the
Division of Information Technology for “Expenses Associated with the
Childhood Immunization Program” for invoices relative to savings from
Procurement and Information Technology Efficiency Initiatives.
·
$86,400 from a lump sum appropriation for “expenses
of mosquito abatement in an effort to curb the spread of West Nile Virus” for
an invoice relative to savings from Procurement Efficiency Initiatives.
·
$79,100 from a lump sum appropriation for
“Operational Expenses for Metabolic Screening Follow-up Services” for an
invoice relative to savings from Procurement Efficiency Initiatives.
·
$35,000 from appropriations for “Grants for
Development of Local Health Departments and the Public Health Workforce,
including Operational Expenses” for an invoice relative to savings from
Procurement Efficiency Initiatives.
·
$683,737 toward procurement and information
technology billings from personal services related line item appropriations.
·
$55,000 toward the procurement efficiency billing
from travel line item appropriations.
The FY05 billings from CMS contained
more detail on where CMS determined the Department saved monies. However, it appears the Department paid
these billings in a manner similar to the previous fiscal year.
The
Department paid a total of $3,453,348 for the efficiency initiative
billings. (Finding 1, pages 10-13)
We recommended that the Department only make payments for efficiency
initiative billings from line item appropriations where savings would be
anticipated to occur. Further, the
Department should seek an explanation from the Department of Central Management
Services as to how savings levels were calculated, or otherwise arrived at,
and how savings achieved or anticipated impact the Department’s budget.
Department officials
accepted our finding and recommendation and stated the Department received
multiple efficiency billings from DCMS in FY04 and FY05 with limited
documentation and the Department did make several efficiency payments from
contractual services, equipment and information technology line items that
most closely aligned themselves with the efficiency initiative billings. However, without additional cost
documentation, the Department allocated its remaining payments to
appropriations that allowed the greatest flexibility to manage administrative
costs, i.e., lump sum appropriations.
In addition, the Department stated that they did attempt to allocate payments,
in addition to GRF, from other non-GRF State funds and it was the
Department’s belief that the DCMS cost savings initiatives would impact
administrative operations in most all of its various operating funds and not
solely impact GRF appropriations.
NONCOMPLIANCE WITH THE STATE OFFICIALS AND
EMPLOYEES ETHICS ACT
The Department did not have
written policies and procedures for timekeeping and reporting hours worked on
official State business. In addition,
the timekeeping system used by the Department did not document hours spent
each day on official State business by employee. (Finding 2, page14)
We recommended the Department
comply with the State Officials and Employees Ethics Act by developing a
written policy regarding timekeeping requirements and requiring employees to
submit timesheets recording time spent on official State business to the
nearest quarter hour.
Department officials accepted our finding
and recommendation and stated that a comprehensive directive on timekeeping
will be issued and posted for all employees to review. In addition, the weekly time sheets
currently utilized for the Central Time and Attendance system will be modified
to include employee signatures as verification of time spent on official
State business to the nearest quarter hour.
FINANCIAL REPORTING IN ACCORDANCE WITH GENERALLY
ACCEPTED ACCOUNTING PRINCIPLES (GAAP)
The Department did not correctly report financial information on the
Grant/Contract Analysis (SCO-563) form to the Office of the State
Comptroller. The Department prepares
a separate SCO-563 form for six funds.
We noted the following errors:
·
The Department
did not calculate (estimate) deferred revenues correctly for federal grants
on one SCO-563 form. The Department
received an additional $1.798 million in revenues during the first 60 days of
the next fiscal year, resulting in the Department overstating deferred
revenues and understating revenues by $1.798 million.
·
The Department did not include a non-cash award on
one SCO-563 form. The non-cash award
was for commodities received from the federal government totaling $24.575
million. As a result of the Department
not including this non-cash award on the SCO-563, the Department also did not
recognize the revenue and expenditure of the non-cash award in the year end
accounting reports filed with the Office of the State Comptroller (GAAP
Package). (Finding 3, pages 15-16)
We recommended the Department comply
with the Statewide Accounting Management System and Governmental Accounting
Standards Board requirements to ensure accurate financial information is
submitted to the Office of the State Comptroller. Further, we recommended the Department review and revise as
necessary its current system used to gather and document the financial
information that will be reported in the Office of the State Comptroller
generally accepted accounting principles (GAAP) Reporting Package Forms.
Department officials accepted our finding and recommendation
and stated that the Department has changed its process to have an estimate
for the revenue that will be made available during the remainder of the lapse
period. In addition, the Department
was under the assumption that only cash assistance is reportable on the
SCO-563 and they have also changed its process to report all non-cash awards
or any direct assistance received from the federal government on the SCO-563
and recognize it as revenue and expenditure in the GAAP package.
LACK OF DISASTER
RECOVERY PLANNING AND TESTING FOR COMPUTER SYSTEMS
The Department did not have a current Disaster Recovery Plan (Plan) and
had not performed comprehensive disaster recovery testing. The Department has identified 11
applications as Category One on the Statewide Critical Application
Listing. One of the criteria for a
Category One application is the annual recovery testing at an off-site
location. The Department had not
conducted annual recovery testing at the off-site location for these
applications.
The Department had established a Plan, which “details the precise
instructions and actions required to recover the time critical information
technology systems and services.”
However, the Plan contained outdated information and the Department
had not developed a Plan for one of the Department’s Category One
applications. (Finding 6, pages
22-23)
We recommended that the Department perform and document tests of its
disaster recovery plan. The tests
should include all critical computing platforms, and systems, and should be
adequately documented. Additionally,
all Category One applications should be subject to annual recovery tests
performed at an off-site location.
Department officials accepted our finding and
recommendation and stated that the Department has worked diligently for the
past two years defining a Business Continuity Program to protect its
constantly changing programs and large number of resources and continues
efforts to maintain plans for all Category One applications as they are
identified. The Department will
coordinate efforts with the Department of Central Management Services to
perform tests on each of the current applications defined in the plan.
NONCOMPLIANCE WITH REPORTING REQUIREMENTS
The Department did not adhere to various
reporting requirements established by State law. We noted the following:
·
The Department
did not submit to the General Assembly a comprehensive plan providing for the
best possible use of available resources for the development of the State’s
human resources and the provision of social services by the Department as
required by the Illinois Welfare and Rehabilitation Services Planning Act (20
ILCS 10/3 and 4).
·
The Department
convened a task force to assess the feasibility and curriculum for a
Certified Nurse Assistant Career Ladders Program, however the task force has
not started the Career Ladders Program or reported its findings and
recommendations to the General Assembly as required by the Nursing Home Care
Act (210 ILCS 45/3-206.04).
·
The Department
did not report to the General Assembly by April 1 of each year upon the
performance of its State long-term care facility licensure inspections,
survey and evaluation duties and its actions in enforcement under this Act as
required by the Nursing Home Care Act (210 ILCS 45/3-804). (Finding 8, pages 26-27) This finding has been repeated since
1997.
We
recommended the Department comply with the various reporting requirements or
seek legislative remedy for statutory mandate provisions. (For previous Department response see
Digest Footnote 1.)
Department
officials accepted our finding and recommendation and stated that the
responsibility for the Illinois Welfare and Rehabilitation Services Planning
Act rests with the Department of Human Services and the Department will seek
a legislative remedy to eliminate the statutory requirement for their
Department. In addition, the
Certified Nurse Assistant Career Ladders Task Force has been created and is
currently meeting and working on the Career Ladder issue. The Annual Report to the General Assembly
has included updates on the progress of this Task Force and is part of the
Nursing Home Care Act Annual Report.
Further, for the past several years, the long-term care program has
listed as a legislative initiative the revision of the reporting date from
April 1 to July 1. The program will
continue to pursue this change to the reporting requirement of the Nursing
Home Care Act.
YOUTH CAMP INSPECTIONS NOT PERFORMED AND LICENSES
NOT ISSUED
The
Department did not perform camp inspections and did not issue license
renewals upon expiration of previous licenses as required by the Youth Camp
Act. We noted the Department did not
issue a renewal license upon expiration of the previous license at December
31 for 90 of 235 camps tested. In
addition, the Department issued a license without performing an inspection
for 4 youth camps. (Finding 9, pages
28-29)
We recommended the Department perform inspections and issue
licenses as required by the Youth Camp Act.
Department officials concurred with our finding and
recommendation and stated that the renewal period is at the end of the
calendar year when most camps are not in operation, e.g. summer camps. Consequently, some renewals are sent to
the camp and no one is there or addresses may have changed. In the last few months Department staff
have initiated a licensing data base that allows for immediate access to
licensing information. The Department
will stress the importance to the licensee of any address changes at the time
of the inspection and in the license renewal letter for the next and
following licensure years.
NO INSPECTIONS OR LICENSES ISSUED ON MIGRANT LABOR
CAMPS
The Department did not inspect migrant labor camps 30 days
prior to camp commencement and licenses were not issued 15 days prior to camp
commencement as required by the Illinois Migrant Labor Camp Law. We noted in 22 of 25 camps tested that the
Department had inspected the camps, but inspections were not timely nor were licenses
issued timely. (Finding 10, pages
30-31)
We recommended the Department comply with the requirements of
the Illinois Migrant Labor Camp Law by inspecting and licensing migrant labor
camps in accordance with State law.
Department officials concurred with our finding and
recommendation and stated that migrant labor camps are based on available
housing, crop growth and the location of the work. These change from year to year and the Department is usually
notified less than 30 days of the date of the operation so an inspection
cannot usually be performed and licenses issued as mandated. The date of operation is determined by the
crop growth which depends on the weather conditions for that year. The operation of migrant camps have
changed somewhat as they were when the law was initially written.
DEPARTMENT DID NOT COMPLY WITH INNOVATIONS IN
LONG-TERM CARE QUALITY GRANTS ACT
The Department did not comply with the Innovations in
Long-term Care Quality Grants Act (Act).
The Department did not establish a long-term care grant program or establish
a commission to review applications for grants. As a result, the Department did not provide grants to long-term
care facilities even though the Department received a $1 million
appropriation in fiscal year 2005 for this purpose. (Finding
11, page 32)
We recommended the
Department comply with the provisions of the Innovations in Long-term Care
Quality Grants Act by establishing a long-term care grant program including
an advisory board that provides grants to long-term care facilities.
Department officials concurred with our
finding and recommendation and stated that this program was not
implemented because of a delay in getting the Commission/Advisory Board
appointed. The Office of Health Care
Regulation was notified on December 6, 2005 that the members of the
Commission have now been approved.
The Department is in the process of setting up the initial meeting of
the Commission which will allow for the process of reviewing and approving
grants under this Act.
TRAVEL HEADQUARTER REPORTS NOT FILED TIMELY OR ACCURATELY
The Department did not file 2 of 4 (50%) Travel Headquarter
Reports (TA-2 Report) with the Legislative Audit Commission. Further, the other two TA-2 Reports that
were filed listed incorrect headquarters for nine employees. (Finding 12, page 33)
We recommended the
Department comply with the requirements of the State Finance Act by filing
accurate Travel Headquarter Reports and in a timely manner.
Department officials
concurred with our finding and recommendation and stated that all required
TA-2 reports for the 2004-2005 audit period have been submitted to the
Legislative Audit Commission and with respect to incorrect headquarters
designations, the Department will work closely with the impacted offices to
ensure proper listings are maintained.
FIELD SANITATION FINES NOT ASSESSED
The
Department did not assess fines to
violators upon inspection of farm operations as required by the Field
Sanitation Act. During our testing we
noted 4 of 8 (50%) field inspections performed during fiscal year 2004 and
2005 did not include the assessment of fines even though violations were
noted on the field inspection forms.
The Department performed 17 inspections in fiscal year 2004 and 16 in
fiscal year 2005, and no fines were assessed for either year. (Finding 15, page 36)
We
recommended the Department comply with all aspects of the requirements of the
Field Sanitation Act.
Department officials
concurred with our finding and recommendation and stated that, generally,
most violations of this Act can and are corrected during the on-site
inspection. The Department's ability
to assess fines for these violations has helped ensure that the violations
are immediately corrected. The
Department will use its authority if the violations pose a severe health risk
to the workers and the community.
RECOMMENDATIONS FROM THE 2001 PROGRAM AUDIT OF THE
ILLINOIS HEALTH FACILITIES PLANNING BOARD NOT FULLY IMPLEMENTED
The Department had not fully
implemented five recommendations made in the Program Audit of the Illinois
Health Facilities Planning Board (September 2001).
·
The first recommendation in the program audit stated
that the Health Facilities Planning Board should assure that when conditions
are required of applicants that those conditions relate to the projects being
considered and comply with the Health Facilities Planning Act.
·
The third recommendation in the program audit stated
that the State agency staff at the Department of Public Health should assure
that evaluation criteria are applied consistently in the projects that they
review and the State Agency Reports that they prepare.
·
The fourth recommendation in the program audit stated
that the Health Facilities Planning Board should examine their review
criteria and make adjustments to the existing criteria or eliminate
duplicative criteria to minimize the domino effect.
·
The sixth recommendation in the program audit stated
that the Board should assure that all applications are treated
consistently. This may require
reviewing how similar projects were treated and may require comparing similar
projects to choose the best one.
·
The seventh recommendation in the program audit
stated that the Board should consider issuing a statement of findings for why
a project is approved or denied. This
should be done for all projects approved as well as projects receiving an
intent-to-deny, an initial denial, and a final denial. For denials, this statement should not
just reiterate the criteria not met in the State Agency Report since most
projects are approved without meeting all criteria. (Finding 16, Pages 37-40)
We
recommended the Health Facilities Planning Board should continue its efforts
to implement recommendations contained in the 2001 Office of the Auditor
General’s program audit. Specifically,
the Planning Board should review the recommendations noted and continue its
efforts to revise its rules, criteria and standards in its effort to ensure
each recommendation is addressed and fully implemented.
The Department concurred with the prior recommendations
and the current status of those recommendations. Regarding Program Audit Recommendation Number 1, the State
Board has addressed this issue during its current rulemaking. Contained in its proposed amendments to
Part 1130 rules, parameters are established for “conditional permits.” These rules have concluded the 1st
Notice process and will be submitted to the Joint Committee on Administrative
Rules (JCAR) for 2nd Notice by the end of April 2006. Regarding Program Audit Recommendation Number
6, the current administrative rules do not allow for a comparative review of
similar applications and do, in fact, state that each application must be
considered on its own merit. Under
specific circumstances, a comparative review or “batching” process is
permissible and is being considered under the State Board’s rules initiative.
OTHER FINDINGS
The remaining findings are reportedly
being given attention by the Department.
We will review the Department’s progress toward the implementation of
our recommendations during our next examination.
Mr. Gary Robinson, Deputy Director of
the Office of Finance and Administration, provided the Department's responses
to our findings and recommendations.
AUDITORS' OPINION
We conducted a compliance examination of the
Department of Public Health as required by the Illinois State Auditing
Act. We have not audited any
financial statements of the Department for the purpose of expressing an
opinion because the Department does not, nor is it required to, prepare
financial statements.
____________________________________
WILLIAM G. HOLLAND, Auditor General
WGH:TLD:pp
AUDITORS
ASSIGNED
This examination was performed by the
Office of the Auditor General’s staff.
DIGEST
FOOTNOTE
#1 NONCOMPLIANCE WITH
REPORTING REQUIREMENTS – PREVIOUS
DEPARTMENT RESPONSE
2003: Agree. This Department has distributed to the
members of the General Assembly its report of the long-term care facility
licensure inspections and is in the process of including a curriculum for a
Certified Nurse Assistant Cancer Ladders Program. The Welfare and Rehabilitation Services are no longer provided
by the Department as those services are the responsibility of the Department
of Human Services. The Department
utilizes a strategic planning process and annual performance management
planning to report on existing Department activities and operations.
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