The state Auditors of Public Accounts have concluded in a report that the Public Health Department does a poor job of accounting for tuberculosis and sexually transmitted disease medications, doesn’t do a good job of monitoring its contracts with health care providers, and needs a system to ensure background checks are performed on all child care providers.
The report, which covers part of former Gov. M. Jodi Rell’s administration under Commissioner Robert Galvin and part of Gov. Dannel P. Malloy’s administration under Commissioner Jewel Mullen, included a long list of 33 recommendations for the agency.
The report released Wednesday covers the fiscal years ending June 30, 2010 to June 30, 2011, and a spokesman said the agency agrees with “virtually all” of the findings.
“Their examination of DPH financial records . . . brought to light many deficiencies and illustrated ineffective internal control over various fiscal and administrative operations,” Public Health Spokesman William Gerrish said in an email. “The findings, which the department received approximately 6 months ago, helped illuminate a much-needed, widespread systems change across the agency.”
He said about two-thirds of the findings have already been fully corrected or almost corrected, including how drugs are accounted for and how background checks for child care providers are managed.
The auditors found that when it comes to TB and STD drugs, “the department has not established a perpetual inventory system for tracking its pharmaceutical inventory. It does not collect data from health care providers concerning their pharmaceutical inventory, returns, and expirations.”
The auditors cited instances in which more drugs were ordered than were needed.
In fiscal year 2010, the agency ordered 108 units of the TB drug Cycloserine when it had 168 units on hand and distributed only 34 units. That year, the department failed to account for 114 units, valued about $22,152. In 2011, the same thing happened when it ordered 173 units with 128 units on hand and distributed 77 units. That year, the department could not account for the 204 unit difference valued at $39,523.
The Department of Public Health told the auditors it is in the process of implementing a perpetual inventory system so it’s better able to track the medications it buys. The new system has been in production since July 1 of this year.
Auditors recommended that the department establish policies and procedures to ensure that purchases of pharmaceuticals are used based on the actual demand of health service providers.
Auditors also tried to look at the performance of 11 health care providers with whom the department contracts for the treatment of sexually transmitted diseases or tuberculosis, but it struggled to find any information about how many people were being served in the clinics or programs prior to 2011. The auditors were told by the department that insufficient staffing was to blame.
But monitoring disease programs wasn’t the auditors’ only complaint. They also found some fault, as they did in a previous audit, with the way the department conducted background checks on child care providers.
“Our review of the department’s licensing files that document site visits to child care facilities found that the files do not contain documented evidence that the department verified [whether] all new child care employees had the required background checks,” auditors wrote in their report.
It relies heavily on a manual process that doesn’t provide them realtime feedback of background-check activity. The DPH doesn’t have the capacity to track current pending legal matters as part of their background checks.
“The department does not have a unified monitoring and enforcement system capable of ensuring that all program employees entering the child care system in Connecticut are identified, that they have received background checks, and follow-up has take place in all instances where a background check reveals legal matters of concern,” auditors concluded.
That means that “child care providers and their employees may be operating without the required completed background checks,” the report found. “As a result, children in licensed child care facilities are at an increased risk of coming into contact with unsuitable individuals.”
Gerrish said the department has taken steps to resolve the matter and is in the process of hiring temporary staff to assist with background checks for day care facilities.
House Minority Leader Lawrence Cafero released a statement today criticizing the department for the findings.
“These troubling findings by the auditors raise serious questions about how this department is being run and whether it takes seriously its core mission to function as the State of Connecticut’s premier health agency,’’ Cafero said. “These violations need to be addressed immediately.’’
In addition, the department is working on getting Emergency Medical Service organizations to report data electronically and according to Gerrish more than half have achieved full compliance with their data reporting requirements.