An audit of Fulton County’s health department, finished late last month, shows a pattern of mismanagement that cost the county money and possibly endangered the health of residents.
The district attorney’s office is considering criminal charges against one former employee, accused of shredding financial documents and skimming money from the department. As a result of poor controls, eligible Medicaid money was not reimbursed, checks were not cashed and cash receipts were misrecorded.
Additionally, an understaffed department fell behind on required restaurant and other food service inspections, which serve to ensure that food safety standards are being met and food-borne diseases do not spread.
“We’re disappointed in it,” said Dick Anderson, the county manager. “We need to implement better systems.”
Fulton Chairman John Eaves called the various issues the audit turned up “unfortunate.” But he said new leadership would help ensure proper safeguards and would improve the county’s track record.
The former head of the department, Patrice Harris, resigned in the fall. There is no evidence that she was aware of, or involved with, the mishandling of funds, Anderson said. The county is interviewing for her replacement this week.
Fulton leaders have already taken steps to mitigate the problems. The issues, which came to light after another audit showed the county had to return millions of dollars in unspent grants for HIV treatment, show the lack of oversight.
Because records have been destroyed, it is impossible to know exactly how much money was lost or not collected as a result of the issues the audit uncovered, county officials say.
Anderson and the interim health director, David Sarnow, said they had begun to make changes in the department before the audit report was completed. The department is no longer responsible for billing and collections, which are now under the purview of the county's finance department. A new accounting supervisor has been hired — the last one resigned before the audit was completed — and staff are being trained on the proper way to manage cash, store records and report receipts.
The audit covered the 2014 calendar year, but parts were extended until mid-2015 because of the destruction of records. In 2014, the department had 344 employees and a $31.6 million budget. County auditor Anthony Nicks said in an email that he was unable to review any records prior to 2014.
“This clearly diminished our audit trail,” he wrote.
Most of the financial issues in the department stemmed from instructions the accounting supervisor gave employees, chief financial officer Sharon Whitmore said.
Many of the audit’s 18 recommendations dealt with small-scale financial issues, but together, they show a disregard for county money and policies.
The audit detailed deposits that were posted twice, uncashed checks worth more than $3,000 that were found in an office filing cabinet and more than $25,000 in Medicaid claims that were denied because of errors in documentation. During the four-month period the auditor inspected, only 12 claims, worth $177.84, were paid.
In the environmental health area where inspections of things such as restaurants, swimming pools take place, 2,237 required inspections were not conducted in a timely fashion. Eight additional employees were hired to help clear up the backlog, but there are still more than 500 overdue inspections that have to be done.
Sarnow, the interim health director, said food-borne illnesses are “not generally well-hidden.” If restaurants passed previous inspections, he said, it is unlikely that their procedures would change to allow them to fail.
Other issues included fees that were charged twice as ownership changed and invoices that were sent to businesses that were closed.
County Commissioner Bob Ellis said he was surprised by the level and lack of internal controls, but that the county had made a lot of changes to ensure that the issues would not repeat themselves.
“It’s not a positive story by any stretch of the imagination,” he said. “It’s a breach of public trust and it occurred in an area where we do a lot of vital things. …I think we are headed in the right direction, but there is a lot more work to be done.”
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