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Auditors Make 33 Recommendations To Public Health Department

by Christine Stuart | Oct 30, 2013 1:14pm
(3) Comments | Commenting has expired
Posted to: Health Care

Christine Stuart file photo

Public Health Commissioner Jewel Mullen

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.

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(3) Comments

posted by: Fisherman | October 30, 2013  9:03pm

Commissioner Jewel Mullen does not bother to read the letters she affixes her signature to.

Case in-point: Her “approval” to pipe water from Middletown to Durham.

posted by: lkulmann | November 2, 2013  11:42am

This is embarrassing…to the nursing profession especially ... Does anyone work in this Department? ((Hello)) Who the hell is going to clean up this disaster zone? I think I’m going to be sick ... I knew all along that this State could care less about its residents. I knew something was very wrong at this Agency when I reported safety issues I encountered working at Yale. I was shocked when The Department of Public Health responded to my complaint by stating they don’t have jurisdiction to address my patient safety concerns especially being an RN. Is it an exaggeration saying this State is not safe from a Public Health standpoint? Do I think that this is common knowledge? There is not one peep of outrage ... of course its common knowledge. everyone just looks the other way. So when does the US Department of Health and Human Services intervene? I hope soon! While they’re at it They can clean up the ACA Marketplace Insurance mess that the DSS calls insurance. There are more federal violations in CT’s ACA than in The Wall Street monstrosity…

posted by: Wiley Coyote | November 4, 2013  9:58am

This is outrageous!  The Department of Correction now has NO TB tests for the inmates OR staff. They just starting reading roll call notices telling us that they are in a shortage of TB tests and that they will be doing a “verbal” test through medical department.  This is an issue that both the Department of Health, Correction Department and AFSCME have known about for months but have failed to act on jeopardizing the publics health.  Correctional Staff can be exposed to TB infected inmates (There are cases every year!) then they pass it on to their kids who then bring it to school an so forth creating an epidemic.  Why are these people who are supposed to be protecting us and getting paid very well, not held accountable?  Governor Malloy needs to step in and heads need to roll, while also acting fast to get us the TB test we so desperately need. Our Local Union along with Council 4 collects our dues for use in “Protecting us”, why have they been so silent to the members they serve, let alone the Public they claim to educate on these matters?  Where has the Leadership in State Government and in the Union’s gone?  It is time for new Commissioners and a new Union!