Wednesday, July 9, 2008

County health department cited for $138K in improper payments

More training, internal audits part of agency’s response to IG review

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Deficiencies at the county’s Department of Health and Human Services resulted in four improper payments totaling almost $138,000 to a behavioral health contractor over three years, according to a review by the county’s inspector general.

The payments to Health Management Consultants, a contractor in Columbia, were approved between June 2005 and July 2008.

The review followed a complaint that HHS practices ‘‘circumvented county regulations.” It found that managers were unable to find key files to support whether the invoices had been reviewed properly or whether the services had been delivered before payments were approved.

‘‘In this instance, it appears that there was end-of-year revenue that a service area chief wanted to be expended for county residents because this was state money and would expire at the end of the [fiscal] year,” said Uma Ahluwalia, who has led HHS since March 2007. ‘‘There was not enough time to dot all the I’s and cross all the T’s.”

The payments came from state community health grants. The complainant alleged that HHS staffers processed the invoices knowing the work had not been performed, and that the end of the fiscal year would have made it ‘‘inconceivable that the contractor had performed the services by year end.”

All of the invoices submitted by HHS staffers were approved near the end of the fiscal years, the review found. The time between approval of a purchase order and the company’s submission of an invoice was seven days or less; in one instance, submission and approval occurred on the same day.

Two staffers no longer work for the county, Ahluwalia said. Neither was fired, but left as the Leggett administration made changes. The final payment was made last year, but the multiyear contract was negotiated before her arrival, Ahluwalia said.

Health Management Consultants did not return a call for comment.

The Inspector General’s Office forwarded its findings to Ahluwalia in May. She has moved to strengthen internal controls, including requiring all contractor monitors to attend contract management and procurement training, internal audits of contract files and payments, and independent reviews by HHS’s financial management team.

The plan has been accepted by Inspector General Thomas J. Dagley.

‘‘This is a good example of why we have an inspector general,” said County Councilman George L. Leventhal (D-At large) of Takoma Park, who heads the council’s HHS Committee. ‘‘I have read [Ahluwalia’s] response, and I think it is satisfactory.

‘‘It would seem this was a useful exercise because it pushes us in the right direction in regards to internal control of the department,” said Duchy Trachtenberg (D-At large) of North Bethesda, a member of the HHS Committee. ‘‘It does concern me when you consider that most of the direct services provided through HHS are provided through contracts, so you have to have controls in place, not just around payment and test obligations, but also management performance.”