County health service misses program objectives for STD/HIV prevention services grant

The OIG released the findings of an audit on the Dallas County Health and Human Services administration of a $7.9 million grant issued to reduce sexually transmitted diseases.

Auditors determined that Dallas County Health and Human Service performed grant agreement activities. However, they did not consistently meet program objectives designed to measure the effectiveness of sexually transmitted disease (STD) and human immunodeficiency virus (HIV) control and prevention activities.

Specifically, Dallas County Health and Human Services did not meet 25 out of 28 program objectives between 2019 and 2021. Additionally, the health department did not ensure expenses were incurred and allocated to the correct grant year. OIG auditors discovered that program administrators could not provide sufficient documentation to support 13 of 22 expenses totaling $90,759 in 2019, 10 of 14 expenses worth $101,939 in 2020, and 10 of 12 expenses totaling $85,425 in 2021.

Additional concerns with the program's administration included a lack of documentation to support the salaries it charged to the STD/HIV prevention program and insufficient security and confidentiality controls to ensure documentation was appropriately maintained.

To assist Dallas County Health and Human Services in meeting program objectives, auditors provided recommendations, including:

• Implement (a) processes to identify when grant activities are not meeting program objectives and (b) initiatives to improve performance.
• Ensure it has processes and controls to limit reimbursement requests to allowable grant activities for the STD/HIV Prevention Services Grant Program.
• Ensure salaries charged to the STD/HIV Prevention Services Grant Program are appropriate and supported.
• Ensure staff with access to confidential information sign an annual confidentiality agreement.

The Texas Department of State Health Services provides funding for the STD/HIV Prevention Services Grant Program via contracts established with local health departments to provide essential services designed to prevent and control the spread of STDs through monitoring, surveilling, and responding to STD outbreaks. For the full audit, visit the OIG website.