Health district did not meet objectives related to STD/HIV prevention services grant

The OIG released the results of a recent audit of the City of Houston Health Department’s administration of a grant to reduce sexually transmitted diseases. 

Auditors determined that from January 1, 2019, through August 31, 2021, the health department did not meet 25 of the 28 program objectives tested (Seven in 2019, nine in 2020, and nine in 2021). Program objectives are designed to measure the effectiveness of the Sexually Transmitted Disease/Human Immunodeficiency Virus (STD/HIV) Prevention Services Grant Program. Of the selected measures, only the goal for the treatment of syphilis was met each year, while testing goals for exposed partners were not. Goals for completing interviews, medical appointments, and partner-testing for clients with HIV also did not meet performance measures outlined within the grant.

The report indicated that program administrators had no processes to ensure that the program spent funding on items and activities occurring within the year the grant was received. Auditors discovered that in 2019 and 2020 more than 40% of the program’s annual grant was spent in the final quarter of the year. This amounted to a lack of documentation on funding expenses worth more than $503,000 over the three-year grant period.

The audit also highlighted the health department’s lack of documentation for employees in the 2019 grant year. Auditors reviewed 40 employee records and discovered they were missing proof of required certifications for the program. This resulted in $79,913 in improperly reported expenses. This concern was initially identified by the Department of State Health Services through a fiscal monitoring review.

To assist the health department in meeting program objectives, auditors provided recommendations, including:

• Implement processes to identify when grant activities are not meeting program objectives and 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.
• Continue to ensure it has processes and controls in place to verify salaries charged to the STD/HIV Prevention Services Grant Program are appropriate and supported with required documentation.

The Texas Department of State Health Services provides funding for the Sexually Transmitted Disease/Human Immunodeficiency Virus Prevention Services Grant Program via contracts established with local health departments to provide essential services to prevent and control the spread of STDs through monitoring, surveilling, and responding to outbreaks.

For the full audit, visit the OIG website.