Department of Community Health budgetary compliance report for the fiscal year ended June 30, 2013 [June 30, 2013]

Fiscal

Year 2013

Department of

Community Health

Budgetary Compliance
Report
For the Fiscal Year Ended June 30, 2013

Department of Audits and Accounts
Greg S. Griffin State Auditor
State Government Division David Pennington, Director

DEPARTMENT OF COMMUNITY HEALTH BUDGETARY COMPLIANCE REPORT
FOR THE FISCAL YEAR ENDED JUNE 30, 2013 -- TABLE OF CONTENTS -- Page COMPLIANCE SECTION
Independent Accountant's Report ........................................................................................................ i Statement of Funds Available and Expenditures Compared to Budget
By Program and Funding Source Budget Fund ............................................................................................................... 1
FINDINGS SECTION Schedule of Findings and Questioned Costs
Summary Schedule of Prior Year Findings and Questioned Costs ........................................ 8

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COMPLIANCE SECTION

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DEPARTMENT OF AUDITS AND ACCOUNTS
270 Washington Street, S.W., Suite 1-156 Atlanta, Georgia 30334-8400
Greg S. Griffin
STATE AUDITOR (404) 656-2180
INDEPENDENT ACCOUNTANT'S REPORT
Mr. Clyde Reese III, Commissioner Department of Community Health
and Members of the Department of Community Health
Ms. LaSham Hughes, Executive Director Georgia Composite Medical Board
and Members ofthe Georgia Composite Medical Board
Ms. Cherri Tucker, Executive Director Georgia Board for Physician Workforce
and Members of the Georgia Board for Physician Workforce
We have examined the Department of Community Health's compliance with the 2013 Appropriations Act, as amended, (Final Budget) and Article VII, Section IV Paragraph VIII of the Constitution of the State of Georgia for fiscal year ended June 30, 2013. Also included in our examination were the following two administratively attached organizations, whose budgets were included in Section 17: Community Health, Department of of the 2013 Amended Appropriations Act:
Georgia Composite Medical Board Georgia Board for Physician Workforce
Management for each of these organizations is responsible for their compliance with the following requirements:
An appropriated budget unit cannot overspend their authorized budgeted amounts at the legal level of budgetary control (funding source within program). This means that amounts reflected in the "variance" column under the heading of Expenditures Compared to Budget in the Statement of Funds Available and Expenditures Compared to Budget by Program and Funding Source Budget Fund are not negative variances.

Article VII, Section IV Paragraph VIII of the Constitution of the State of Georgia provides, in part, "...the credit of the State shall not be pledged or loaned to any individual, company, corporation or association." As applied here, this means that amounts reflected in the "variance" column under the heading of Excess (Deficiency) of Funds Available Over/(Under) Expenditures in the Statement of Funds Available and Expenditures Compared to Budget by Program and Funding Source Budget Fund are not negative variances.

Our responsibility is to express an opinion on compliance with the aforementioned requirements for the Department of Community Health and the two administratively attached organizations based on our examination.

Except as discussed in the following paragraph, our examination was conducted in accordance with attestation standards established by the American Institute of Certified Public Accountants and, accordingly, include examining, on a test basis, evidence about the Department of Community Health's and the two administratively attached organizations' compliance with those requirements and performing such other procedures as we considered necessary in the circumstances. We believe that our examination provides a reasonable basis for our opinion. Our examination does not provide a legal determination on the aforementioned organizations' compliance with the specified requirements; however, our report may be useful to legal counsel or others in making such determinations.

During the year under review, the Department of Audits and Accounts maintained a contractual obligation with the Department of Community Health to conduct certain non-audit services.

In our opinion, the Department of Community Health and the two administratively attached organizations complied, in all material respects, with the aforementioned requirements for the fiscal year ended June 30, 2013.

A summary of our opinions on compliance for the Department of Community Health and the administratively attached organizations is as follows:

Organization
Department of Community Health Georgia Composite Medical Board Georgia Board for Physician Workforce

Unqualified Qualified Adverse Disclaimer Opinion Opinion Opinion (No Opinion) X X X

A separate management report will be issued to the Board and management of the Department of Community Health and the two administratively attached organizations, as applicable, disclosing other information pertinent to the financial and compliance activities of the organization.

ii

This report is intended solely for the information and use of the Board and management of the Department of Community Health and the two administratively attached organizations and management of the State of Georgia. including the Governor and the Georgia General Assembly. This report is not intended to be and should not be used by anyone other than these specified parties. However, this report is a matter of public record and its distribution is not limited.
Respectfully submitted,

November 14, 2013

Greg S. Griffin State Auditor

111

Department of Community Health
Statement of Funds Available and Expenditures Compared to Budget By Program and Funding Source Budget Fund For the Fiscal Year Ended June 30, 2013

Departmental Administration and Program Support State Appropriation State General Funds Federal Funds Medical Assistance Program State Children's Insurance Program Federal Funds Not Specifically Identified American Recovery and Reinvestment Act of 2009 Medical Assistance Program Promote Health Info Tech Other Funds
Total Departmental Administration and Program Support
Aged, Blind and Disabled Medicaid State Appropriation State General Funds Nursing Home Provider Fees Hospital Provider Payments Federal Funds Federal Funds Not Specifically Identified Medical Assistance Program American Recovery and Reinvestment Act of 2009 Medical Assistance Program Other Funds
Total Aged, Blind and Disabled Medicaid
Health Care Access and Improvement State Appropriation State General Funds Federal Funds Medical Assistance Program Federal Funds Not Specifically Identified American Recovery and Reinvestment Act of 2009 Medical Assistance Program Promote Health Info Tech Other Funds
Total Health Care Access and Improvement
Indigent Care Trust Fund State Appropriation State General Funds Federal Funds Medical Assistance Program Other Funds
Total Indigent Care Trust Fund
Low-Income Medicaid State Appropriation State General Funds Tobacco Settlement Funds Hospital Provider Payments Federal Funds Medical Assistance Program Federal Funds Not Specifically Identified American Recovery and Reinvestment Act of 2009 Medical Assistance Program Other Funds
Total Low-Income Medicaid
PeachCare State Appropriation State General Funds Hospital Provider Payments Federal Funds State Children's Insurance Program Other Funds
Total PeachCare
State Health Benefit Plan Other Funds

Original Appropriation

Amended Appropriation

$

67,136,937.00 $

75,199,302.00 $

231,288,579.00 23,036,955.00 652,490.00

231,016,519.00 23,036,955.00 652,490.00

686,408.00 583,731.00 23,956,230.00

686,408.00 583,731.00 24,286,230.00

347,341,330.00

355,461,635.00

1,213,014,554.00 157,444,961.00 25,488,041.00
2,787,214.00 2,757,878,376.00
336,131,620.00
4,492,744,766.00

1,415,638,461.00 167,756,401.00 25,451,911.00
2,787,214.00 3,165,857,597.00
336,131,620.00
5,113,623,204.00

7,317,234.00
416,250.00 172,588.00
13,018,046.00 7,941,462.00
-
28,865,580.00

6,967,234.00
416,250.00 172,588.00
13,018,046.00 7,941,462.00
-
28,515,580.00

-
257,075,969.00 150,450,219.00
407,526,188.00

16,622,029.00
293,604,986.00 152,890,433.00
463,117,448.00

789,037,546.00 110,193,257.00 208,186,737.00
2,170,012,694.00 -
36,720,780.00
3,314,151,014.00

754,932,688.00 118,493,257.00 207,891,625.00
2,119,997,265.00 -
36,720,780.00
3,238,035,615.00

77,951,094.00 1,627,249.00 250,346,470.00
151,783.00 330,076,596.00
2,987,734,959.00

96,955,921.00 1,624,942.00 310,514,043.00
151,783.00 409,246,689.00
3,069,017,237.00

Final Budget

Funds Available Compared to Budget

Current Year

Prior Year

Revenues

Carry-Over

75,199,302.00 $
264,895,456.00 23,036,955.00
6,796,601.00
1,494,100.00 235,731.00
19,346,600.00
391,004,745.00

75,199,302.00 $

-

259,054,142.99

-

22,928,446.69

-

4,395,575.93

-

1,343,570.93 115,294.40
20,797,319.48

16,076,003.95

383,833,652.42

16,076,003.95

1,415,638,461.00

1,415,638,461.00

-

176,864,128.00

176,864,128.00

-

25,111,059.00

25,111,059.00

-

21,434,993.00

17,006,564.65

-

3,495,525,041.00

3,334,164,254.87

-

145,829.00

145,828.62

-

373,473,117.00

373,503,451.51

-

5,508,192,628.00

5,342,433,747.65

-

6,967,234.00
5,085,017.00
7,463,419.00 4,986,089.00
13,161.00
24,514,920.00

6,967,234.00
4,693,024.41
7,263,065.84 4,490,400.57
-
23,413,724.82

-
-
13,160.35
13,160.35

16,622,029.00
298,281,173.00 139,306,132.00
454,209,334.00

16,622,029.00
288,234,506.26 136,729,187.16
441,585,722.42

-
2,572,314.04
2,572,314.04

754,932,688.00

754,932,688.00

-

118,493,257.00

118,493,257.00

-

205,344,405.00

205,344,405.00

-

2,256,405,269.00

2,167,618,558.24

-

4,500,000.00

3,472,842.04

-

80,728,751.00

78,663,126.91

-

43,717,049.00

42,735,130.17

-

3,464,121,419.00

3,371,260,007.36

-

96,955,921.00

96,955,921.00

-

1,624,559.00

1,624,559.00

-

310,579,018.00

282,149,157.62

-

302,149.00

267,690.17

-

409,461,647.00

380,997,327.79

-

3,069,017,237.00

3,069,602,960.48

-

1

Available Compared to Budget Program Transfers Or Adjustments

Total Funds Available

Variance Positive (Negative)

Expenditures Compared to Budget

Variance

Actual

Positive (Negative)

Excess (Deficiency) of Funds Available
Over/(Under) Expenditures

$

-$

75,199,302.00 $

-$

72,875,659.32 $

2,323,642.68 $

2,323,642.68

-

259,054,142.99

(5,841,313.01)

259,054,142.99

5,841,313.01

-

-

22,928,446.69

(108,508.31)

22,928,446.69

108,508.31

-

-

4,395,575.93

(2,401,025.07)

4,395,575.93

2,401,025.07

-

-

1,343,570.93

-

115,294.40

-

36,873,323.43

(150,529.07) (120,436.60) 17,526,723.43

1,343,570.93 115,294.40
15,978,787.83

150,529.07 120,436.60 3,367,812.17

20,894,535.60

-

399,909,656.37

8,904,911.37

376,691,478.09

14,313,266.91

23,218,178.28

-

1,415,638,461.00

-

176,864,128.00

-

25,111,059.00

-

17,006,564.65

-

3,334,164,254.87

-

145,828.62

-

373,503,451.51

-

5,342,433,747.65

-
(4,428,428.35) (161,360,786.13)
(0.38) 30,334.51
(165,758,880.35)

1,265,562,630.48 176,864,128.00 25,111,059.00
17,006,564.65 3,334,164,254.87
145,828.62 373,473,116.78
5,192,327,582.40

150,075,830.52 -
4,428,428.35 161,360,786.13
0.38 0.22
315,865,045.60

150,075,830.52 -
-
30,334.73
150,106,165.25

-
-
(13,160.35)
(13,160.35)

6,967,234.00
4,693,024.41
7,263,065.84 4,490,400.57
-
23,413,724.82

-
(391,992.59)
(200,353.16) (495,688.43) (13,161.00)
(1,101,195.18)

6,747,688.10
4,693,024.41
7,263,065.84 4,490,400.57
-
23,194,178.92

219,545.90
391,992.59
200,353.16 495,688.43 13,161.00
1,320,741.08

219,545.90
-
-
219,545.90

-

16,622,029.00

-

288,234,506.26

-

139,301,501.20

-

444,158,036.46

-
(10,046,666.74) (4,630.80)
(10,051,297.54)

16,622,028.96
288,234,506.26 134,782,779.35
439,639,314.57

0.04
10,046,666.74 4,523,352.65
14,570,019.43

0.04
4,518,721.85
4,518,721.89

-

754,932,688.00

-

118,493,257.00

-

205,344,405.00

-

2,167,618,558.24

-

3,472,842.04

-

78,663,126.91

-

42,735,130.17

-

3,371,260,007.36

-
(88,786,710.76) (1,027,157.96)
(2,065,624.09) (981,918.83)
(92,861,411.64)

742,121,457.18 118,493,257.00 205,344,405.00
2,167,618,558.24 3,472,842.04
78,663,126.91 42,716,910.35
3,358,430,556.72

12,811,230.82 -
88,786,710.76 1,027,157.96
2,065,624.09 1,000,138.65
105,690,862.28

12,811,230.82 -
-
18,219.82
12,829,450.64

-

96,955,921.00

-

1,624,559.00

-

282,149,157.62

-

267,690.17

-

380,997,327.79

-

3,069,602,960.48

(28,429,860.38) (34,458.83) (28,464,319.21)
585,723.48

86,718,557.31 1,624,559.00 282,149,157.62
267,690.17 370,759,964.10
2,834,175,054.26

10,237,363.69 -
28,429,860.38 34,458.83
38,701,682.90
234,842,182.74

10,237,363.69 -
-
10,237,363.69
235,427,906.22 (continued)

2

Department of Community Health
Statement of Funds Available and Expenditures Compared to Budget By Program and Funding Source Budget Fund For the Fiscal Year Ended June 30, 2013

Healthcare Facility Regulation State Appropriation State General Funds Federal Funds Federal Funds Not Specifically Identified Medical Assistance Program Other Funds

Original Appropriation
7,124,146.00
5,521,905.00 2,939,995.00
100,000.00

Amended Appropriation
6,959,146.00
5,419,605.00 2,877,295.00
100,000.00

Total Healthcare Facility Regulation

15,686,046.00

15,356,046.00

Agencies Attached for Administrative Purposes

Georgia Composite Medical Board State Appropriation State General Funds Other Funds

2,046,154.00 100,000.00

2,002,998.00 100,000.00

Total Georgia Composite Medical Board

2,146,154.00

2,102,998.00

Georgia Board for Physician Workforce: Board Administration State Appropriation State General Funds

685,128.00

678,277.00

Georgia Board for Physician Workforce: Graduate Medical Education State Appropriation State General Funds

8,917,518.00

8,708,629.00

Georgia Board for Physician Workforce: Mercer School of Medicine Grant

State Appropriation

State General Funds

20,969,911.00

20,969,911.00

Georgia Board for Physician Workforce: Morehouse School of Medicine Grant

State Appropriation

State General Funds

10,671,474.00

10,671,474.00

Georgia Board for Physician Workforce: Undergraduate Medical Education

State Appropriation

State General Funds

2,731,636.00

2,647,228.00

Georgia Board for Physician Workforce: Physicians for Rural Areas State Appropriation State General Funds

830,000.00

830,000.00

Budget Unit Totals

$ 11,971,078,300.00 $ 12,738,981,971.00 $

Final Budget
6,959,146.00 5,820,605.00 4,364,136.00
100,000.00 17,243,887.00
2,002,998.00 365,597.00
2,368,595.00
678,277.00
8,708,629.00
20,969,911.00
10,671,474.00
2,647,228.00
830,000.00 13,384,639,931.00

Funds Available Compared to Budget

Current Year

Prior Year

Revenues

Carry-Over

6,959,146.00

-

5,188,702.17

-

4,125,517.60

-

607,601.83

-

16,880,967.60

-

2,002,998.00

-

350,357.62

-

2,353,355.62

-

678,277.00

-

8,708,629.00

-

20,969,911.00

-

10,671,474.00

-

2,647,228.00

-

830,000.00

-

$

13,076,866,985.16 $ 18,661,478.34

3

Available Compared to Budget Program Transfers Or Adjustments
-
-
-

Total Funds Available
6,959,146.00
5,188,702.17 4,125,517.60
607,601.83
16,880,967.60

Variance Positive (Negative)
-
(631,902.83) (238,618.40) 507,601.83
(362,919.40)

Expenditures Compared to Budget

Variance

Actual

Positive (Negative)

6,535,684.93
5,188,702.17 4,125,517.60
100,000.00
15,949,904.70

423,461.07
631,902.83 238,618.40
-
1,293,982.30

Excess (Deficiency) of Funds Available
Over/(Under) Expenditures
423,461.07
507,601.83
931,062.90

-

2,002,998.00

-

350,357.62

-

2,353,355.62

(15,239.38)
(15,239.38)

1,929,334.05 350,357.62
2,279,691.67

73,663.95 15,239.38
88,903.33

73,663.95 -
73,663.95

-

678,277.00

-

547,978.18

130,298.82

130,298.82

-

8,708,629.00

-

8,695,727.28

12,901.72

12,901.72

-

20,969,911.00

-

20,969,910.96

0.04

0.04

-

10,671,474.00

-

10,671,474.00

-

-

-

2,647,228.00

-

2,647,228.00

-

-

-

830,000.00

-

830,000.00

-

-

$

(13,160.35) $ 13,095,515,303.15 $

(289,124,627.85) $ 12,657,810,043.85 $

726,829,887.15 $

437,705,259.30

4

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FINDINGS SECTION

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DEPARTMENT OF COMMUNITY HEALTH Schedule of Findings and Questioned Costs For the Fiscal Year Ended June 30, 2013

SUMMARY SCHEDULE OF PRIOR YEAR FINDINGS AND QUESTIONED COSTS

FINDING CONTROL NUMBER AND STATUS

FS-419-12-100 FS-419-12-101 FS-419-12-102 FS-419-12-103

Previously Reported Corrective Action Implemented Previously Reported Corrective Action Implemented Previously Reported Corrective Action Implemented Previously Reported Corrective Action Implemented

8

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